How accurate are physical examination findings for diagnosing disc herniation?

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Abstract

EVIDENCE-BASED ANSWER

In patients with back pain and sciatica, the straight leg test has the best sensitivity (92%) for diagnosing disk herniation but has a specificity of only 28%. Specificities for other tests are better, with many at least 90%. The femoral nerve stretch test has the best specificity at 99%, but its sensitivity is only 17% (SOR: A, meta-analysis of cohort studies and single cohort study using CT and surgery as the gold standards for diagnosis).

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