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Clinical neurological examination vs electrophysiological studies: Reflections from experiences in occupational medicine.

Authors
  • Jepsen, Jørgen Riis
Type
Published Article
Journal
World journal of methodology
Publication Date
Jun 26, 2015
Volume
5
Issue
2
Pages
26–30
Identifiers
DOI: 10.5662/wjm.v5.i2.26
PMID: 26140269
Source
Medline
Keywords
License
Unknown

Abstract

Seventy-five percent of upper limb disorders that are related to work are regarded as diagnostically unclassifiable and therefore challenging to the clinician. Therefore it has been generally less successfully to prevent and treat these common and frequently disabling disorders. To reach a diagnosis requires the identification of the responsible pathology and the involved tissues and structures. Consequently, improved diagnostic approaches are needed. This editorial discusses the potentials of using the clinical neurologic examination in patients with upper limb complaints related to work. It is argued that a simple but systematic physical approach permits the examiner to frequently identify patterns of neurological findings that suggest nerve afflictions and their locations, and that electrophysiological studies are less likely to identify pathology. A diagnostic algorithm for the physical assessment is provided to assist the clinician. Failure to include representative neurological items in the physical examination may result in patients being misinterpreted, misdiagnosed and mistreated.

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