Competing opinions

Posted By Sue on October 25, 1998 at 01:30:14:







I am an attorney looking to research the efficacy of certain opinions,
one given by a neurologist and the other by an orthopaedist.  The patient
presented with low back pain radiating into her legs mostly on the right
side after lifting an object.  The neurologist, upon clinical examination, concluded she had
lumbar radiculopathy and asked for an MRI, suspecting disc herniation.  The MRI showed mild dessication (desiccation)
and minimal bulges at L4/L5.  Nerve conduction studies of the lower extremities
were normal but emg of the lumbar area was significant at three levels.  The
patient also had spina bifida as a child and certain congenital anomalies
were found.  Despite the MRI being negative, the neurologist still believes
the patient has lumbar radiculopathy.  The orthopaedist says that this
diagnosis cannot be made from the diagnostic testing.  Can someone tell me
how one can test for malingering or feigning during a clinical neurological
examination.  Also, are there diagnostic tests that bring out malingering?