Prevalence of Cervical Radiculopathy, Carpal Tunnel Syndrome, and Double Crush Syndrome in Patients with Cervical Radiculopathy-like Symptoms: A Retrospective Electromyography and Magnetic Resonance Imaging Study

A BSTRACT Objective: To determine the prevalence of cervical radiculopathy (CR), carpal tunnel syndrome (CTS), and double crush (DC) syndrome in patients presenting with upper-extremity symptoms suggestive of CR and to assess their relationship with magnetic resonance imaging (MRI)-based classifications of cervical disc herniations. Methods: In this retrospective cross-sectional study, 106 adults who underwent electromyography (EMG) for suspected CR between May 2023 and December 2024 were analyzed. EMG findings defined isolated CR, CTS, or DC syndrome; cervical MRIs were scored via the foramen-facet-spinal (FFS) system. Patients with prior cervical or hand surgery, systemic/rheumatic disease, neurologic disorders, malignancy, or chemotherapy history were excluded. Results: Of 126 symptomatic limbs, 15.9% had isolated CR, 18.3% had CTS, 5.6% had DC syndrome, and 60.3% had no EMG-detectable pathology. The C6 (41%) and C5 (32%) roots were most frequently involved in CR. Among 68 patients with MRI data, AB-zone herniations predominated. CR correlated significantly with B and AB zones ( P = 0.049), whereas zone A was less associated with radiculopathy. Conclusion: In patients with CR-like symptoms, CR, CTS, and DC syndromes can be diagnosed through EMG examination. Combined EMG and MRI evaluation is important, especially for AB region herniations. Although MRI provides guidance in terms of FFS classification and diagnostic insights, further research is needed to elucidate the mechanisms of radicular pain.