Neck pain differential diagnosis: Difference between revisions
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{{Neck pain}} | {{Neck pain}} | ||
==Overview== | ==Overview== | ||
There is extensive differential diagnosis for neck pain.Varity of diseases manifest as neck pain.The most causes are biomechanical | |||
axial neck pain, whiplash associated disorder (WAD),radiculopathy, cervical myelopathy, infection, neoplasm, rheumatic causes, trauma, referred pain and fibromyalgia. | |||
==Differentiating neck pain from other Diseases== | ==Differentiating neck pain from other Diseases== | ||
There is extensive differential diagnosis for neck pain.Varity of diseases manifest as neck pain.The most causes are biomechanical | |||
axial neck pain, whiplash associated disorder (WAD),radiculopathy, cervical myelopathy, infection, neoplasm, rheumatic causes, trauma, referred pain and fibromyalgia.<ref name="pmid15575026">{{cite journal| author=Douglass AB, Bope ET| title=Evaluation and treatment of posterior neck pain in family practice. | journal=J Am Board Fam Pract | year= 2004 | volume= 17 Suppl | issue= | pages= S13-22 | pmid=15575026 | doi=10.3122/jabfm.17.suppl_1.s13 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15575026 }} </ref> | |||
===Differentiating neck pain from other diseases === | |||
===Differentiating neck pain from other diseases | |||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical strain]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical strain]] | ||
| | |Pain , stiffness on neck movement | ||
| | |Tenderness on palpation of neck and [[Trapezius muscle|trapezius]] muscles | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[["Whiplash" injury]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Whiplash injury|"Whiplash" injury]] | ||
| | |Pain on neck movement following an abrupt extension–flexion type injury ,headache, shoulder or back pain, dizziness, [[Paresthesia|paresthesias]], fatigue | ||
| | |Decreased range of motion associated with neck spasm | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical discogenic pain]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical disc disease|Cervical discogenic pain]] | ||
| | |Pain , stiffness on neck movement,cervical radicular symptoms | ||
| | |Decreased range of motion with pain | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical myofascial pain]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical myofascial pain]] | ||
| | |Focal pain and pressure sensitivity;accompanied by a sensation of burning or stinging | ||
| | |Localized tenderness | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical radiculopathy]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical radiculopathy]] | ||
| | |Pain, numbness,tingling in a dermatomal distribution,weakness in upper extremity | ||
| | |Decreased or altered sensation, diminished [[Deep tendon reflex|deep tendon reflexes]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical spondylotic myelopathy]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cervical spondylotic myelopathy]] | ||
| | |Lower extremity weakness, gait or coordination difficulties, and bowel or bladder dysfunction | ||
| | |Focal neurologic signs in upper and/or lower, Lhermitte's sign | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ossification of the posterior longitudinal ligament]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ossification of the posterior longitudinal ligament]] | ||
| | |neck pain, progressive [[radiculopathy]], [[myelopathy]] symptoms | ||
| | |Focal neurologic signs in upper and/or lower extremities | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tension headache]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tension headache]] | ||
| | |Bilateral headache, which may be associated with neck pain; no other neurologic symptoms | ||
| | |Localized tenderness on palpation of scalp and neck,no neurologic abnormalities | ||
| | | | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Coronary artery disease]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Coronary artery disease]] | ||
| | |Chest pain with radiation to neck | ||
| | |Normal | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infection]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infection]] | ||
| | |Fever,depending on nature of infection | ||
| | |depending on nature of infection | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malignancy]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Malignancy]] | ||
| | |Unexplained weight loss | ||
| | |Localized tenderness on palpation of spine | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Referred shoulder pain ]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Referred shoulder pain ]] | ||
| | |Shoulder pain with radiation to neck | ||
| | |Localized tenderness on shoulder exam | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polymyalgia rheumatica]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Polymyalgia rheumatica]] | ||
| | |morning stiffness in shoulders | ||
| | |Decreased range of motion of joints | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fibromyalgia]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fibromyalgia]] | ||
| | |Diffuse musculoskeletal pain with fatigue | ||
| | |Multiple soft tissue "tender points | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thoracic outlet syndrome]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Thoracic outlet syndrome]] | ||
| | |Upper extremity neurologic paresthesias,swelling, pain in the hand | ||
| | |Focal neurologic signs in upper extremities, sensory deficits, swelling, cyanosis or pallor | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Esophageal obstruction]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Esophageal obstruction]] | ||
|Dysphagia | |[[Dysphagia]] | ||
|Normal | |Normal | ||
|} | |}<ref name="pmid15575026">{{cite journal| author=Douglass AB, Bope ET| title=Evaluation and treatment of posterior neck pain in family practice. | journal=J Am Board Fam Pract | year= 2004 | volume= 17 Suppl | issue= | pages= S13-22 | pmid=15575026 | doi=10.3122/jabfm.17.suppl_1.s13 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15575026 }} </ref><ref name="pmid19445809">{{cite journal| author=Binder AI| title=Neck pain. | journal=BMJ Clin Evid | year= 2008 | volume= 2008 | issue= | pages= | pmid=19445809 | doi= | pmc=2907992 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19445809 }} </ref><ref name="pmid17369782">{{cite journal| author=Binder A| title=The diagnosis and treatment of nonspecific neck pain and whiplash. | journal=Eura Medicophys | year= 2007 | volume= 43 | issue= 1 | pages= 79-89 | pmid=17369782 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17369782 }} </ref> | ||
<ref name="pmid25963463">{{cite journal| author=Capó-Juan MA| title=[Cervical myofascial pain syndrome. Narrative review of physiotherapeutic treatment]. | journal=An Sist Sanit Navar | year= 2015 | volume= 38 | issue= 1 | pages= 105-15 | pmid=25963463 | doi=10.23938/ASSN.0058 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25963463 }} </ref> | |||
==References== | ==References== | ||
Latest revision as of 15:49, 23 February 2021
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Overview
There is extensive differential diagnosis for neck pain.Varity of diseases manifest as neck pain.The most causes are biomechanical axial neck pain, whiplash associated disorder (WAD),radiculopathy, cervical myelopathy, infection, neoplasm, rheumatic causes, trauma, referred pain and fibromyalgia.
Differentiating neck pain from other Diseases
There is extensive differential diagnosis for neck pain.Varity of diseases manifest as neck pain.The most causes are biomechanical axial neck pain, whiplash associated disorder (WAD),radiculopathy, cervical myelopathy, infection, neoplasm, rheumatic causes, trauma, referred pain and fibromyalgia.[1]
Differentiating neck pain from other diseases
| Diseases | symptoms | physical examination | |
|---|---|---|---|
| Cervical strain | Pain , stiffness on neck movement | Tenderness on palpation of neck and trapezius muscles | |
| "Whiplash" injury | Pain on neck movement following an abrupt extension–flexion type injury ,headache, shoulder or back pain, dizziness, paresthesias, fatigue | Decreased range of motion associated with neck spasm | |
| Cervical discogenic pain | Pain , stiffness on neck movement,cervical radicular symptoms | Decreased range of motion with pain | |
| Cervical myofascial pain | Focal pain and pressure sensitivity;accompanied by a sensation of burning or stinging | Localized tenderness | |
| Cervical radiculopathy | Pain, numbness,tingling in a dermatomal distribution,weakness in upper extremity | Decreased or altered sensation, diminished deep tendon reflexes | |
| Cervical spondylotic myelopathy | Lower extremity weakness, gait or coordination difficulties, and bowel or bladder dysfunction | Focal neurologic signs in upper and/or lower, Lhermitte's sign | |
| Ossification of the posterior longitudinal ligament | neck pain, progressive radiculopathy, myelopathy symptoms | Focal neurologic signs in upper and/or lower extremities | |
| Tension headache | Bilateral headache, which may be associated with neck pain; no other neurologic symptoms | Localized tenderness on palpation of scalp and neck,no neurologic abnormalities | |
| Coronary artery disease | Chest pain with radiation to neck | Normal | |
| Infection | Fever,depending on nature of infection | depending on nature of infection | |
| Malignancy | Unexplained weight loss | Localized tenderness on palpation of spine | |
| Referred shoulder pain | Shoulder pain with radiation to neck | Localized tenderness on shoulder exam | |
| Polymyalgia rheumatica | morning stiffness in shoulders | Decreased range of motion of joints | |
| Fibromyalgia | Diffuse musculoskeletal pain with fatigue | Multiple soft tissue "tender points | |
| Thoracic outlet syndrome | Upper extremity neurologic paresthesias,swelling, pain in the hand | Focal neurologic signs in upper extremities, sensory deficits, swelling, cyanosis or pallor | |
| Esophageal obstruction | Dysphagia | Normal |
References
- ↑ 1.0 1.1 Douglass AB, Bope ET (2004). "Evaluation and treatment of posterior neck pain in family practice". J Am Board Fam Pract. 17 Suppl: S13–22. doi:10.3122/jabfm.17.suppl_1.s13. PMID 15575026.
- ↑ Binder AI (2008). "Neck pain". BMJ Clin Evid. 2008. PMC 2907992. PMID 19445809.
- ↑ Binder A (2007). "The diagnosis and treatment of nonspecific neck pain and whiplash". Eura Medicophys. 43 (1): 79–89. PMID 17369782.
- ↑ Capó-Juan MA (2015). "[Cervical myofascial pain syndrome. Narrative review of physiotherapeutic treatment]". An Sist Sanit Navar. 38 (1): 105–15. doi:10.23938/ASSN.0058. PMID 25963463.