Differential Dx of Neck Pain part 2 Flashcards
(50 cards)
What are the red flag for possible infection?
Age Over 50 Years Age Under 20 Years Fever or Chills Pain worse supine Recent Urinary Tract Infection IV Drug Abuse Immune Suppression
What are some red flags for cervical infection in the physical examination?
Fever
Spinous process percussive pain (only C2, C7, T1)
What are some red flags for cervical infection that could be seen in lab test?
Elevated WBC count
Elevated erythrocyte sedimentation rate
What are some infections that cause cervical neck pain?
Sinusitis Cervical Adenitis Parotitis Lyme Arthritis Osteomyelitis
What are the red flag for possible tumor in the cervical region?
Age over 50 years Age under 20 years Unexplained Weight Loss Pain worse when Supine Severe Nocturnal Pain History of cancer (has metastatic cancer until proven otherwise)
When doing the physical exam for circulatory disorders what should you look for and auscultate?
BP, Pulse Rate
Palpate Carotid Pulses (presence, character, thrill)
Heart (murmurs)
Carotid Arteries (bruits)
Vertebral Arteries at mastoid processes (bruits)
Ophthalmic Arteries over the eyeballs (bruits)
What are the red flags for vertebrobasiliar artery compromise?
Acute anxiety or panic on the part of the patient during any part of the examination or treatment (Ischemia)
Sitting pt look up toward the ceiling then turn the head to right
What test is NOT recommended for possible vertebrobasiliar artery compromise?
DeKleyn Test
What would ellict a wallenburg syndrome and what are its symptoms?
Vertebrobasiliar thrombosis
Homolateral face pain and paresthesia, contralateral loss of pain and temp sensation, vertigo w/ vomiting, unilateral paralysis of palate, pharynx and vocal cords
What is the history finding for mechanical abnormalities?
Insidious onset
What are some mechanical abnormalities of the cervical spine?
Somatic Dysfunction Kyphosis with Anterior Head Carriage Scoliosis Poor Posture Poor Muscle Tone Scapulo-Costal Syndrome Hypermobility
What constitutes about 30% of all neck and shoulder complaints in mid-life?
Scapulo-costal syndrome
Also called: fatigue postural paradox syndrome or levator scapulae syndrome
What does the posture look like in scapulo-costal syndrome?
Inc kyphosis with anterior head carriage with muscular neck, shoulder and back pain
Where does the pain localize to in scapulo-costal syndrome?
Superior medical corner of the scapula
What exacerbates the pain in scapulo-costal syndrome?
Elevation and adduction of the humerous
What sound could you hear if someone has scapulo-costal syndrome?
Crepitance due to facial scarring when circumducted
What is the treatment for scapulo-costal syndrome?
Correct Kyphosis Correct Scoliosis Correct Associated Cervical, Thoracic, Costal and Clavicular Somatic Dysfunctions Balance Shoulder muscle tension Trigger Point Treatment
What are some counterstrain treatments for scapulo-costal syndrome?
Counterstrain Muscle Energy Deep Inhibitory Pressure Spray & Stretch Injection of Lidocaine/Corticosteroids
What is intern’s neck and what is it caused by?
Neck and shoulder pain
Excessive Pull on the Suspensory Muscles of the shoulders
Due to overloading white coat pockets
How can you releive some of the pain in intern’s neck?
Transfer the weight off the shoulders onto pelvis
Where can hypermobility occur and what could cause it?
Anywhere
Laxity of ligaments due to genetic factors, degenerative discs, ligament trauma
What are the treatments for localized hypermobility?
OMT Exercise Bracing Prolotherapy Surgical fusion
What is Elhers-Danols syndrome?
A group of inherited disorders that affect connective tissue due to defects in collagen production
What type of Ehlers-Danols is hypermobility and what are the symptoms?
Type III
Loose connective tissue and chronic joint pain
Also called Benign Hypermobility Syndrome or Arthrochalasis Multiplex Congenita
