Concordance Between Clinical Preliminary Diagnoses and Electrophysiological Findings in EMG Referrals: A Retrospective Analysis

Abstract Objective To evaluate the concordance between clinical preliminary diagnoses and electrophysiological diagnoses obtained through electromyography (EMG) in patients referred with suspected entrapment neuropathies or polyneuropathy. Methods In this retrospective descriptive study, 3,683 EMG reports from patients referred to the EMG unit of Samsun Physical Medicine and Rehabilitation Hospital between June 1, 2023, and February 10, 2025, were reviewed. All EMG procedures were conducted and reported by the same physiatrist. Patient age, sex, clinical preliminary diagnoses, and final electrophysiological results were recorded. Statistical significance was set at p < 0.05. Results Of the patients, 75.4% were female, with a mean age of 54.6 ± 14.1 years. The most common referral diagnoses were carpal tunnel syndrome (CTS) (62.4%), polyneuropathy (PNP) (34.1%), cubital tunnel syndrome (CuTS) (2.6%), meralgia paresthetica (MP) (0.7%), and tarsal tunnel syndrome (TTS) (0.2%). EMG results were normal in 45.4% of cases. Clinical and EMG diagnoses matched in 47.35% of patients, while 7.25% received different electrophysiological diagnoses. Concordance was statistically significant for CTS, CuTS, and MP (p < 0.001). Concordance rates were moderate in CTS (49.8%) and PNP (42.6%), substantial in CuTS (51.1%) and MP (52.0%), and low in TTS (25.0%). Sensitivity was 99.6% for CTS and 99.8% for PNP, while specificity was 54.4% and 77.08%, respectively. Conclusion The concordance between clinical and EMG diagnoses was generally moderate. Especially in CTS and PNP, specificity was low. Improving clinical assessment may help enhance diagnostic accuracy and reduce unnecessary testing and patient wait times.