Straight leg test sometimes used to help diagnose a lumbar herniated disc<unk>  is typically diagnosed by physical examination, and the history of the symptoms. Physical tests Generally if a person reports the typical radiating pain in one leg as well as one or more neurological indications of nerve root tension or neurological deficit,<unk>  can be diagnosed. The most applied diagnostic test is the straight leg raise to produce Lasègue's sign, which is considered positive if pain in the distribution of the<unk> nerve is reproduced with passive flexion of the straight leg between 30 and 70 degrees. While this test is positive in about 90% of people with<unk> , approximately 75% of people with a positive test do not have<unk> . Straight raising the leg unaffected by<unk>  may produce<unk>  in the leg on the affected side; this is known as the Fajersztajn sign. The presence of the Fajersztajn sign is a more specific finding for a herniated disc than Lasègue's sign. Maneuvers that increase intraspinal pressure, such as coughing, flexion of the neck, and bilateral compression of the jugular veins, may worsen<unk> . Medical imaging Imaging modalities such as computerised tomography or magnetic resonance imaging can help with the diagnosis of lumbar disc herniation. The utility of MR neurography in the diagnosis of piriformis syndrome is controversial. Discography could be considered to determine a specific disc's role in an individual's pain. Discography involves the insertion of a needle into a disc to determine the pressure of disc space. Radiocontrast is then injected into the disc space to assess for visual changes that may indicate an anatomic abnormality of the disc. The reproduction of an individual's pain during discography is also diagnostic. Differential diagnosis Cancer should be suspected if there is previous history of it, unexplained weight loss, or unremitting pain. Spinal epidural abscess is more common among those with diabetes mellitus or immunocompromised or who had spinal surgery, injection or catheter; it typically causes fever, leukocytosis and increased erythrocyte sedimentation rate. If cancer or spinal epidural abscess are suspected, urgent magnetic resonance imaging is recommended for confirmation. Proximal diabetic neuropathy typically affects middle aged and older people with well-controlled type-2 diabetes mellitus; onset is sudden causing pain usually in multiple dermatomes quickly followed by weakness. Diagnosis typically involves electromyography and lumbar puncture. Shingles is more common among the elderly and immunocompromised; usually (but not always) pain is followed by appearance of a rash with small blisters along a single dermatome. Acute Lyme radiculopathy may follow a history of outdoor activities during warmer months in likely tick habitats in the previous 1–12 weeks. In the U.S., Lyme is most common in New England and Mid-Atlantic states and parts of Wisconsin and Minnesota, but it is expanding to other areas. The first manifestation is usually an expanding rash possibly accompanied by flu-like symptoms. Lyme can also cause a milder, chronic radiculopathy an average of 8 months after the acute illness.
Sciatica
Shingles
Calpainopathy
Epicondylitis
Carpal tunnel syndrome
Balanitis
Distal myopathy
Heel pad syndrome