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Neck pain

  • Common ddx

    • cervical strain, osteoarthritis, whiplash, radiculopathy, fibromyalgia
  • Serious ddx

    • c-spine fracture, retropharyngeal abscess, meningitis, tumor, dissection
  • Labs

    • xray to dx degenerative changes
    • CT to dx abscess
    • MRI to dx myelopathy, radiculopathy
    • LP to dx meningitis
    • ESR, antibody panel to dx rheumatic issues
  • Myelopathy ddx

    • MS, syringomyelia, spondylosis
  • Radiculopathy ddx

    • pinched nerve, herpes zoster, lyme radiculopathy
  • Muscle ddx

    • cervical strain, fibromyalgia, dystonia
  • Trauma ddx

    • whiplash, c-spine fracture, cervical strain
  • Vascular ddx

    • vertebral artery dissection, carotid artery dissection, thoracic outlet syndrome
  • Rheumatic ddx

    • PMR, temporal arteritis, fibromyalgia, RA
  • Infection ddx

    • retropharyngeal abscess, epidural abscess, meningitis, shingles prodrome, shingles, lyme
  • Malignancy ddx

    • esophageal cancer, laryngeal cancer, bone tumor, metastatic cancer
  • Referred pain ddx

    • MI, angina, gallstone, apical lung tumor, impingement, adhesive capsulitis, rotator cuff tear
  • Other ddx

    • dystonia, tension headache, diabetic neuropathy
  • HPI

    • onset
    • triggering event
    • location: anterior, posterior, lateral, axial, skin, muscle, throat, windpipe
    • quality: sharp, dull, stiffness
    • radiation to shoulder, upper extremity, down spine (Lhermittes)
    • severity
    • alleviates, aggravates
  • ROS

    • fever, weight loss, nightsweats
    • trauma
    • rash
    • headache
    • vision changes
    • dysphagia, odynophagia, neck mass
    • chest pain, dyspnea, cough
    • nausea, vomiting, diarrhea, abdominal pain
    • paresthesia, muscle weakness, incontinence
    • upper extremity pain, swelling
  • PMH

    • OA, RA, PMR, fibromyalgia
    • neck surgeries
    • cancers
    • diabetes
  • FH

  • SH

  • Meds

  • Allergies

  • Px

    • vitals
    • gen impression, posture
    • skin: rash, petechiae
    • head: trauma
    • neck: inspect, palpate c-spine, ROM, strength
    • arm: strength, reflex, finger sensation, edema
    • cardio
    • pulm
    • abd: tenderness
    • neuro: strength, reflex, sensation, ataxia, gait

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.