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Monograph: Musculoskeletal mimics for lumbosacral radiculopathy Part 2
Monograph: Musculoskeletal mimics for lumbosacral radiculopathy. Part 2: Specific disorders
Abstract
Lumbosacral radiculopathy is a common disorder evaluated by the electrodiagnostic medicine (EDX) consultant. Making this task difficult is the abundance of radiculopathy mimics. Peripheral neurologic mimics are common, but musculoskeletal mimics are not rare and may be less familiar to many EDX consultants. Awareness of the most common musculoskeletal mimickers—particularly key historical and physical examination features that can distinguish them from radiculopathies—can lead to an accurate diagnosis for the patient and referring provider. Part 1 of this
monograph covered theoretical issues surrounding why radiculopathy mimics occur. This second part reviews the most common musculoskeletal mimics, including facet arthropathy, myofascial pain syndrome, hip pathology, greater trochanteric pain syndrome, piriformis syndrome, sacroiliac joint dysfunction, hamstring pathology, iliotibial band syndrome, and plantar fasciitis. Diagnosis of these musculoskeletal mimickers is complicated by nonspecific physical examination and imaging findings, and diagnostic injections are frequently necessary to confirm the diagnosis. Treatment for most mimickers includes physical therapy, antiinflammatory medications, guided injections, and other conservative measures, only rarely followed by surgical intervention. EDX consultants can efficiently incorporate a few high-yield maneuvers into their physical examination based on the location of the pain to provide answers to patients presenting with a musculoskeletal mimic of a lumbosacral radiculopathy.

Objectives: The objectives of this activity are to:1) Use the location of symptoms to facilitate the differential diagnosis of patients presenting with symptoms of lumbosacral radiculopathy; 2) Consider the risk factors that predispose to the various musculoskeletal syndromes mimicking lumbosacral radiculopathy; 3) Order appropriate diagnostic testing when evaluating patients with lumbosacral radiculopathy.

ACCREDITATION STATEMENT
The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

DISCLOSURE INFORMATION
The authors declare no conflicts of interest.

CREDIT DESIGNATION
The AANEM is accredited by the American Council for Continuing Medical Education (ACCME) to providing continuing education for physicians. AANEM designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  
Authors
Anthony E. Chiodo MD and Shawn P. Jorgensen MD
Summary
Availability: On-Demand
Expires on Nov 01, 2027
Cost: Member: $0.00
Non-Member: $15.00
Credit Offered:
1 CME Credit
1 CEU Credit


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