Differentiate radiculopathy from myelopathy clinically.

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The main idea is to distinguish where the problem lies: at a nerve root versus the spinal cord.

Radiculopathy (nerve root problem) typically shows symptoms in a dermatomal distribution with corresponding myotomal weakness, and there are signs specific to the involved nerve root, such as positive nerve root tension tests (like a positive straight-leg raise for lumbar roots or Spurling’s test for cervical roots). You’ll often see pain radiating along a particular limb path, with sensory and motor changes confined to the affected root’s distribution and reflex changes limited to that level.

Myelopathy (spinal cord problem) presents with upper motor neuron signs that are usually below the level of the lesion. That includes hyperreflexia, a spastic or gait disturbance, and the Babinski sign. There may be a sensory level and bilateral involvement, and symptoms can be more diffuse rather than confined to a single dermatomal pattern.

So, if symptoms align with a single nerve root’s distribution and root-specific signs, radiculopathy is favored. If there are UMN features, gait changes, or a clear sensory level indicating spinal cord involvement, myelopathy is favored.