Which examination maneuver is most commonly used to provoke symptoms in suspected cervical radiculopathy?

Prepare for the Individual Readiness Assurance Test (iRAT) 4 in Head and Neck. Study with multiple-choice questions, comprehensive explanations, and detailed flashcards. Maximize your chances of success with thorough preparation and insightful study resources.

Provoking cervical nerve root symptoms is best done with a maneuver that compresses the nerve roots as they exit the spine. The Spurling maneuver does exactly this: patient sits, the neck is extended slightly and laterally flexed toward the symptomatic side, and an axial load is applied through the skull. If a sharp radiating pain or paresthesias travel down the same arm in the dermatomal pattern of a cervical nerve root, the test is considered positive. This directly tests for foraminal compression or nerve root irritation underlying cervical radiculopathy.

The other tests target different problems. Roos test assesses thoracic outlet syndrome by stressing the shoulder girdle and attempting to provoke neurovascular symptoms with arm elevation. Phalen maneuver and Tinel sign are classic for distal nerve entrapment at the wrist or along peripheral nerves, such as carpal tunnel syndrome, not for cervical radiculopathy.