Which finding is most indicative of a herniated lumbar disc with radiculopathy?

• A. Bilateral leg edema
• B. Normal gait
• C. Positive straight-leg raise with dermatomal sensory changes
• D. Hyperreflexia at the knees

Answer: (C)

Radiculopathy from a lumbar disc herniation presents with signs that point to nerve root irritation rather than a generalized or non-neurologic problem. A positive straight-leg raise indicates nerve root tension and reproduces radicular leg pain when the affected nerve roots are stressed, usually L5–S1. When this pain occurs in a dermatomal distribution and there are sensory changes in that same pattern, it confirms that the nerve root is being compressed or irritated along its specific pathway.

This combination—nerve-root–specific pain provoked by a straight-leg raise plus dermatomal sensory changes—is the strongest indication of a herniated disc causing radiculopathy because it directly ties the clinical findings to the nerve root distribution.

In contrast, bilateral leg edema is a vascular issue, a normal gait doesn't reveal nerve root pathology, and hyperreflexia at the knees suggests an upper motor neuron or central process rather than isolated lumbar nerve root compression.