Which neurologic screening test is best for ruling in cervical radiculopathy?

• A. Positive Spurling's Test
• B. Reduced or absent Biceps DTR
• C. Upper Limb Tension Test
• D. Neck Flexion Test

Answer: (B)

Ruling in cervical radiculopathy involves identifying specific clinical signs that are strongly associated with this condition. In this context, the test that is best for confirming the diagnosis is the assessment of deep tendon reflexes (DTR), particularly the biceps reflex.

The biceps DTR is crucial because it assesses the function of the C5 spinal nerve root, which is often involved in cervical radiculopathy. When the biceps DTR is reduced or absent, it indicates that there may be involvement of the C5 nerve root, which is a common finding in cases of cervical radiculopathy. This makes the absence or reduction of this reflex a strong indicator towards confirming the diagnosis rather than merely suggesting it.

The other tests have value in a comprehensive evaluation but are not as definitive for ruling in cervical radiculopathy. For instance, while a positive Spurling’s test can suggest nerve root compression, it is not exclusive to radiculopathy and may not definitively confirm it. The Upper Limb Tension Test is more focused on neural tension and does not specifically isolate the nerve root's integrity in the same manner. The Neck Flexion Test primarily evaluates for signs of meningeal irritation rather than cervical radiculopathy itself.

In summary, the absence