What is the difference between a non-diagnostic and diagnostic EMG?

[friedpasta1]

Thank you for your time. I am just now being evaluated because of symptoms which might point to ALS, including fasciculations, trouble with handwriting (started in 2019) and finger movements, and some odd perceived weakness in my right arm and leg (I know it's just "perceived" but that's the best way to explain). I've had problem in recent years with both my achilles and rotator cuff type issues but they hadn't been evaluated; I just kind of ignored it and perhaps has been masking some thingssss.

Yesterday I had an EMG and the report today showed mild carpal tunnel, not a surprise, but everything else normal. However, it also says "not diagnostic for periphal neuropathy, radiculopathy, or a myopathy". The PCP order for the EMG indicated the reason as "hyperreflexia" and "fasciculations". But the EMG report indication says "pain/stiffness". I do have stiffness (I think) but not really pain, more of a discomfort. I'm not sure why they even went there.

The doctor is experienced of many years, and tested my right arm mainly from the elbow down and the leg from mainly knee down, at least from what I recall. I might have missed a couple. He also did needle the left calf one time. The neuro appointment isn't for a couple of weeks. Did I just get a "wasted" EMG?

 

[Nikki J]

It doesn’t matter what the indications were. If there was ALS it would have been obvious. It is like having a chest xray to check for pneumonia. If you have lung cancer or congestive heart failure they will see that no matter what the ordering doctor said. Same thing here

the not diagnostic for sounds like just the way the doctor phrases things. If your emg was normal it is normal. Congratulations

 

[friedpasta1]

Thank you for your response. There is definitely something going on, and the EMG doesn't totally relieve my anxiety about it possibly being ALS, but your kind response has certainly relieved some of that anxiety. Thank you for taking the time to respond and help.

 

[lgelb]

As Nikki says, the EMG picks up what it picks up. As for the indication on the report, these support reimbursement by insurance companies or other payors such as Medicare. Docs know they can't just cut and paste from PCP orders, especially.

Don't waste time chasing ALS; follow the evidence so whatever conditions need to be addressed can be. As Nikki says, in this context "non-diagnostic" says "These are the things the machine and I did not see."

Best,
Laurie