Monograph: Musculoskeletal mimics for lumbosacral radiculopathy Part 2-Link to article

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This monograph, authored by Shawn P. Jorgensen and Anthony E. Chiodo, focuses on differentiating musculoskeletal disorders that closely mimic lumbosacral radiculopathy, a condition frequently assessed by electrodiagnostic medicine (EDX) consultants. Part 1 of the monograph explored theoretical reasons for why these mimics occur, while Part 2 delves into specific disorders such as facet arthropathy, myofascial pain syndrome (MPS), hip pathology, greater trochanteric pain syndrome (GTPS), piriformis syndrome, sacroiliac joint (SIJ) dysfunction, hamstring pathology, iliotibial band (ITB) syndrome, and plantar fasciitis.<br /><br />The document outlines how these conditions can present with symptoms similar to radiculopathy, complicating diagnosis. It emphasizes that typical physical examinations and imaging may not be conclusive, thus stressing the importance of accurate diagnostic tools like needle electromyography (EMG), diagnostic injections, and imaging studies.<br /><br />For example, the diagnosis of facet joint arthropathy requires medial branch blocks due to a lack of specific physical exam findings. Myofascial pain syndrome is diagnosed based on clinical evaluation and presence of trigger points but lacks reliable testing methods. Each condition discussed, such as hip labral pathology, GTPS, and piriformis syndrome, has specific characteristics but often requires a combination of examination, imaging, and sometimes diagnostic injections for accurate identification.<br /><br />The monograph suggests a structured approach integrating high-yield examination maneuvers to efficiently assess musculoskeletal mimics. Treatments often involve conservative measures such as physical therapy and NSAIDs, while injections and surgical options are rarely necessary unless other treatments fail. Ultimately, the intent is to enhance the ability of EDX consultants in providing accurate diagnoses and effective treatment plans for patients experiencing what appears to be lumbosacral radiculopathy.

Keywords

musculoskeletal disorders

lumbosacral radiculopathy

electrodiagnostic medicine

facet arthropathy

myofascial pain syndrome

diagnostic tools

needle electromyography

hip pathology

piriformis syndrome

treatment plans