Genevay et al reported the RAPIDH score for identifying radicular pain associated with lumbar disc herniation. The authors are from multiple hospitals in Europe and the United States.
Patient selection: radicular pain (lumbar disc herniation versus spinal stenosis)
Parameter:
(1) monoradicular leg pain distribution
(2) unilateral decreased ankle reflex
(3) femoral stretch (L3 and L4) or straight leg raise (SLR, L5 and S1)
(4) unilateral muscle weakness
(5) patient reported unilateral leg pain
Parameter
Finding
Points
monoradicular leg pain
no
0
yes
6
unilateral decreased ankle reflex
no
0
yes
4
femoral stretch or SLR
negative
0
positive femoral stretch or SLR less than 60 degrees
4
unilateral muscle weakness
no
0
yes
3
patient reported unilateral leg pain
no
0
yes
3
total RAPIDH =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• A score >= 10 was positive for lumbar disc herniation..
Performance:
• The area under the ROC curve was 0.90 with sensitivity 0.71 and specificity 0.90.
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