Tests

Tests to consider

MRI spine

Test
Result
Test

Recommended if there are any new acute neurologic or functional changes.[42]

Perform as needed.

Result

vertebral body or spinal cord lesions

EMG

Test
Result
Test

Can be used if a focal compression neuropathy is suspected.

Can help differentiate symptoms with a peripheral source from those with a central source such as the cord.

Perform as needed.

Result

etiology and localization of neuromuscular pathology

urodynamic studies

Test
Result
Test

Required for proper assessment of coordinated urinary bladder and sphincter function.[45]

Follow-up studies can be used to monitor the evolution of the dysfunction and detect response to medications.[43]

Perform as needed.

Result

urinary bladder and sphincter function; bladder pressures; bladder capacity and compliance; bladder spasticity

bladder ultrasound

Test
Result
Test

Used to assess retention and completeness of bladder emptying.

Used in conjunction with a renal ultrasound to detect urinary tract stones.

Perform as needed and annually with a renal ultrasound.[43][44]

Result

incomplete bladder emptying; urinary tract stones

renal ultrasound

Test
Result
Test

Used in conjunction with a bladder ultrasound to assess the health of the urinary system.

Perform annually with a bladder ultrasound.[44]

Result

identifies renal stones, hydronephrosis, pyelonephritis, and scarring

micturition cystourethrogram

Test
Result
Test

A dynamic and invasive assessment of the flow mechanism.

Used to visualize bladder hypertrophy and other pathology.

Perform as needed.

Result

incomplete bladder emptying; obstruction; bladder reflux to the kidney; bladder hypertrophy

bone densitometry (DEXA)

Test
Result
Test

Used to assess loss of bone density and response to medical management.

Perform every 1-2 years depending on severity of bone loss.[46][47]

Result

bone density changes

laboratory evaluation

Test
Result
Test

Should be checked annually as part of health maintenance screening: complete blood count; comprehensive metabolic panel with magnesium, calcium, and phosphorus; liver function panel; lipid panel; hemoglobin A1c; 25-hydroxy vitamin D level.

Consider metabolic bone markers (e.g., C-telopeptide, osteocalcin, procollagen type 1 N propeptide) in conjunction with endocrine specialty to assess bone turnover.

Result

changes in health, organ system, cardiovascular disease risk factors, bone metabolism

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