Differential Diagnosis of Neck Pain Flashcards
(141 cards)
What are some etiologies of neck pain?
Congenital Disorders Trauma Mechanical Abnormalities Toxicity Metabolic Disorders Inflammatory States Degenerative & Acquired Spinal Diseases Infections
What are some more etiologies of neck pain?
Temporomandibular Joint Dysfunction Thoracic Outlet Syndrome Neoplasms Circulatory Disorders Neurologic Disorders Referred Pain Iatrogenic Psychoneuroses
What is the “job one” in neck pain diagnosis?
Rule Out Any Life, Limb, Organ , and Function Threatening Conditions
During diagnosis, what demographics make you worry?
Age Less Than 20 years Age Over 50 years
During diagnosis, what vital signs make you worry?
Fever Hypertension
During diagnosis, what type of medical history makes you worry?
Trauma Fever Abrupt Onset Neurologic Symptoms (Radicular Pain, Muscle Weakness, Muscle Cramps, Decreased Sensation)
During diagnosis, what findings in the pt’s physical make you worry?
RROM severely restricted (<1/2 the normal range), Radicular symptoms provoked by ROM, Signs of Inflammation, Neurologic Deficits
Major Category: Congenital Disorders
Condition Present Since Childhood, Onset of Symptoms often Insidious, and Symptoms may appear At Any Age, but usually in the late teens to mid-thirties
Major Category: Trauma
Any history of trauma
Major Category: Mechanical
Insidious Onset
Major Category: Toxins
Exposure to toxins: Vocational, Avocational, Incidental
Major Category: Metabolic Disorders
Endocrine: DM, Thyroid disease. Nutrition: Ingestion, digestion, excretion
Major Category: Inflammatory
Abrupt onset: Redness, tumor, fever and pain.
Major Category: Degenerative
Age 50 and older, need imaging
Major Category: Infectious
Fever, WBC elevated, need imaging
Major Category: Neoplasm
Age 50 and older, need imaging
Major Category: Circulatory
-Vital Signs: Pulse rate, Blood Pressure. -Physical Exam: Palpate Pulses, Auscultate Heart, Auscultate Arteries
Major Category: Neurologic
Muscle Weakness or Spasm, Reflex Alterations, Sensory Loss, Pain which follows the distribution of: Nerve Root, Peripheral Nerve
Major Category: Iatrogenic
History of Presence of Iatrogen (caused by another physician)
Major Category: Psychogenic
Diagnosis of exclusion
Patients with possible trauma and/or fall…
Yield possibility of fracture
When you suspect fracture, what are the possible observations in the pt’s PE?
Unusual head carriage, careful palpation of cervical SP, percussion of SP of C2 &C7, severely restricted active ROM.
When you suspect fracture, what is a must do ?
X-ray of the pt’s complete cervical spine
When you suspect fracture, what should you avoid ?
Passive motion testing