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De berekening van de kans op 3 aandoeningen wordt gemaakt op basis van resultaten uit 13 betrouwbare studies. Het algoritme extraheert deze gegevens uit de database en berekent nakansen aan de hand van voorkansen en positieve en negatieve likelihoodratio's. De uitkomst van de berekening is uiteraard een statistische inschatting en onderhevig aan diverse onzekerheden. Lees over de belangrijke statistische tekortkomingen.

Anamnese

Plasklachten
Claudicatio intermittens
Bilaterale plantaire paraesthesie

Klinische tekens

Passive lumbar extension test
Atrofie gastrocnemius (kuit)
Slump test
Zwakke enkel dorsiflexie
Straight Leg Raising test
Abnormale enkelreflex
Abnormaal gevoel in de benen

Aanvullend

CT voor HNP
MRI voor HNP

Voorkansen

Nakansen




Studies gebruikt in deze berekening

1.Majlesi J et al. The Sensitivity and Specificity of the Slump and the Straight Leg Raising Tests in Patients With Lumbar Disc Herniation. Journal of clinical rheumatology: practical reports on rheumatic & musculoskeletal diseases 14(2):87-91 · May 2008
2.Ekedahl H et al. Accuracy of Clinical Tests in Detecting Disk Herniation and Nerve Root Compression in Subjects With Lumbar Radicular Symptoms. Archives of Physical Medicine and Rehabilitation Volume 99, Issue 4, April 2018, Pages 726-735
3.Omar S et al. Accuracy of straight leg raise test in patients with lumbar disc Herniation keeping magnetic resonance imaging as a reference Standard. Pak Armed Forces Med J 2016; 66(1):53-56
4.David S at al. Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices. Am Fam Physician. 2008 Oct 1;78(7):835-842
5.Cecin AH Cecin's Sign: improving the diagnosis of radicular compression by herniated lumbar disks. Rev. Bras. Reumatol. vol.50 no.1 São Paulo Jan./Feb. 2010
6.Ferrari S et al. A literature review of clinical tests for lumbar instability in low back pain: validity and applicability in clinical practice. Chiropr Man Therap. 2015; 23: 14
7.Ebell MH et al. A literature review of clinical tests for lumbar instability in low back pain: validity and applicability in clinical practice. Chiropr Man Therap. 2015; 23: 14
8.Deville WL et al. The test of Lasègue: systematic review of the accuracy in diagnosing herniated discs. Spine (Phila Pa 1976). 2000 May 1;25(9):1140-7
9.Suri P et al. Does this older adult with lower extremity pain have the clinical syndrome of lumbar spinal stenosis? JAMA. 2010 Dec 15;304(23):2628-36
10.Chawalparit O et al. The limited protocol MRI in diagnosis of lumbar disc herniation. J Med Assoc Thai. 2006 Feb;89(2):182-9
11.Rijn RM et al. Computed tomography for the diagnosis of lumbar spinal pathology in adult patients with low back pain or sciatica: a diagnostic systematic review. European Spine Journal February 2012, Volume 21, Issue 2, pp 228–239
12.Brinjikji W et al. MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2015 Dec;36(12):2394-9
13.Schroeder GD et al. Lumbar Spinal Stenosis: How Is It Classified? J Am Acad Orthop Surg. 2016 Dec;24(12):843-852