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Unnecessary Cervical Discectomy - A simple test to differentiate between Cervical and Shoulder Pathology: A Case
George Ampat1, Jonathan M G Sims2, Samantha J Rhodes2
1School of Medicine, Institute of Life Course & Medical Sciences, Faculty of Health & Life Sciences, University of Liverpool, Liverpool, United Kingdom.
Journal of Orthopaedic Case Reports
|November 16, 2022
Summary
The arm-squeeze test aids in distinguishing neck versus shoulder issues, preventing unnecessary surgery when MRI scans are inconclusive. This simple test improves diagnostic accuracy for arm symptoms.
Area of Science:
- Orthopedic Surgery
- Diagnostic Imaging
- Neurology
Background:
- Differentiating neck and shoulder pathology is challenging due to overlapping symptoms.
- Magnetic resonance imaging (MRI) hypersensitivity can lead to misinterpretation of findings.
- The arm-squeeze test is a valuable clinical tool for differential diagnosis.
Observation:
- A 41-year-old male presented with bilateral arm numbness and paresthesia.
- Anterior cervical discectomy and fusion did not resolve symptoms.
- Post-operative evaluation suggested shoulder pathology as the cause.
Findings:
- The arm-squeeze test is underutilized in clinical practice.
- It effectively differentiates between cervical spine and shoulder conditions.
- This test can guide surgical decisions and prevent unnecessary interventions.
Implications:
- Routine use of the arm-squeeze test can improve diagnostic accuracy.
- It may reduce the incidence of failed surgical interventions for unclear arm symptoms.
- Disseminating knowledge of this test is crucial for clinicians managing shoulder and neck pain.
