Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
Spine (Phila Pa 1976). 2013 Feb 1;38(3):257-63. doi: 10.1097/BRS.0b013e318268c8bc.
Prospective study on a diagnostic test.
To determine the usefulness of hip abductor power assessment in the differential diagnosis of foot drop due to lumbar radiculopathy and peroneal neuropathy.
Foot drop arises from various neuromuscular conditions. Differential diagnosis obvious in the typical case, however, is often inconclusive. There are few reports regarding the validity of hip abductor power in the differential diagnosis of foot drop.
Sixty-one consecutive patients who presented with tibialis anterior weakness Medical Research Council grade of less than 3 were included and underwent neurological examination including the assessment of hip abductor power. Patient demographics, mechanism and pattern of foot drop, neurological findings, and the diagnoses were recorded. Final diagnoses were established on the basis of clinical information, imaging studies, and electrophysiological study in limited cases. Validity and reliability of the hip abductor power assessment in the differential diagnosis of foot drop due to lumbar radiculopathy and peroneal neuropathy were evaluated.
There were 44 men and 17 women, with a mean age of 46.8 years (19-77 yr). The final diagnosis was peroneal neuropathy in 28 patients, lumbosacral plexopathy in 9 patients, lumbar radiculopathy in 21 patients, and sciatic nerve disorder in 3 patients. Concomitant hip abductor weakness was found in 85.7% of lumbar radiculopathy and 3.6% of peroneal neuropathy. The sensitivity and specificity of hip abductor power in the differential diagnosis of foot drop due to the lumbar radiculopathy and peroneal neuropathy were 85.7% and 96.4%, respectively. The positive and negative predictive values were 94.7% and 90%, respectively.
Assessment of hip abductor strength is a simple and useful method in the differential diagnosis of foot drop due to lumbar radiculopathy and peroneal neuropathy.
诊断测试的前瞻性研究。
确定髋关节外展肌力评估在腰椎神经根病和腓总神经病所致足下垂鉴别诊断中的作用。
足下垂可由多种神经肌肉疾病引起。在典型病例中，鉴别诊断很明显，但通常无法得出明确结论。关于髋关节外展肌力在足下垂鉴别诊断中的有效性的报道很少。
共纳入 61 例因胫骨前肌肌力不足（美国医学研究理事会分级低于 3 级）而就诊的连续患者，并进行了神经学检查，包括髋关节外展肌力评估。记录患者的人口统计学资料、足下垂的发病机制和模式、神经学发现以及诊断。在有限的情况下，根据临床信息、影像学研究和电生理研究确定最终诊断。评估髋关节外展肌力评估在腰椎神经根病和腓总神经病所致足下垂鉴别诊断中的有效性和可靠性。
患者中男性 44 例，女性 17 例，平均年龄 46.8 岁（19-77 岁）。最终诊断为腓总神经病 28 例，腰骶丛神经病 9 例，腰椎神经根病 21 例，坐骨神经病变 3 例。腰椎神经根病患者中 85.7%存在髋关节外展肌无力，腓总神经病患者中 3.6%存在髋关节外展肌无力。髋关节外展肌力在腰椎神经根病和腓总神经病所致足下垂鉴别诊断中的敏感性和特异性分别为 85.7%和 96.4%。阳性和阴性预测值分别为 94.7%和 90%。
髋关节外展肌力评估是一种简单而有用的方法，可用于腰椎神经根病和腓总神经病所致足下垂的鉴别诊断。
