Clustered clinical findings for diagnosis of CSM

CSM diagnosis is made with what?

Imaging confirmation.

What 5 things demonstrated the capacity to rule out CSM?

Gait Deviation

+Hoffmans test

Inverted supination sign

+Babinski test

>45 yo

Does CSM have a single sign or symptom?

How is the onset?

No

Insidious w/ long periods of episodic progression and varies patient to patient

CSM may involve what extremity first?

What may also be affected?

LE and cause weakness of legs and spasticity

UE which causes strength loss, atrophy, difficulty with finger movements

What are 4 other signs of CSM?

Neck stiffness, shoulder pain, paraethesias in one or both hands, radiculopathic signs

What is the best method of confirming Cervical Stenosis, cord compression, myelomalacia, and elements germane to CSM?

MRI

Why is MRI the most useful tool?

Looks at amount of compression placed on SC and highly sensitive and specific

Individually, Hoffmans, DTR, inverted supinator sign, babinskis sign and clonus are specific or sensitive?

Why is this bad?

Specific

Only used to rule in suspected condition vs ruling out and may lad to false negatives and positives

How do you improve diagnostic accuracy of the 5 tests?

Luster them together

Dx of CSM requires what 2 things

MRI and clinical findings

Pts with CSM presented with what 4 characteristics?

Older, longer duration of symptoms, lower SF12 symptoms and higher BMI

If <1 of 5 are positive, pt most likely does have or does not have CSM?

Does not

MRI has been found to correlate with what 2 things?

Pre op severity of cervical compressive myelopathy and prognosis after surgery

Is exclusive use of MRI for CSM dx appropriate?

No

Why isn’t there a cluster of finding for CSM?

Due to conditional dependence

Why is gait useful?

Gait change associated with Upper motor neuron changes involving CST and SCT, notable in CSK