Common upper c spine syndromes

Question 1

rheumatoid arthritis

Answer 1

Systemic disease
More common in females
Usually appears in midlife 40 to 50
Synovitis is a major feature

Question 2

synovitis

Answer 2

Synovial membrane becomes inflamed

Joint becomes swollen, painful, and feels puffy

Persistent process of inflammation and joints leads to Cartilage erosion and subchondral bony proliferation

Question 3

RA effects on cervical spine

Answer 3

Loosening effect on ligaments of Atlantoaxial joint

synovitis of facet joints

Muscular aches

Fatigue

Question 4

Treatment considerations for RA and cervical spine

Answer 4

never manipulate
Encourage gentle movement and active ROM exercises

Provide support, Heat and pain relieving modalities during inflammation episodes

Be aware of treatment meds like steroids NSAIDs

Question 5

acute wry neck

Answer 5

torticollis

static protective deformity

Occurs between C2 and C7 but more usually at C2/3

Manifest rising in the morning

Characterized by antalgic posture of slight flexion and sidebending away from the painful side

Question 6

3 mechanisms for acute wry neck

Answer 6

meniscoid villus- impacted synovial inclusion

Peri articular congestion/ localized irritability without inclusion

Slow shift of cervical disk substance- lower c

Question 7

two types of wry neck

Answer 7

Type one facet
Type two disc

Question 8

type one wry neck

Answer 8

facet
onset sudden particular movement

Onset on waking, during the night or at any time during the day

pain unilaterally localized to pillar of neck does not commonly spread

Easily relieved by a single treatment by localized, mobilization or manipulation

Question 9

type 2 wry neck

Answer 9

disc
onset commonly on waking in the morning

pain occupy one side of the base of the neck and spreads unilaterally to the yoke area and middle region of the scapula and may spread down outer and posterior arm, sometimes as far as the elbow

Can be badly provoked by localized, mobilization or manipulation

Requires sustained traction flexion, or rotational distraction maneuvers

Takes longer to relieve

Question 10

cervical joint locking

Answer 10

facet joint is the cause of pain

considered to be impaction of synovial fold , or joint capsule itself between the articular joint surfaces

typical patient is young at athletic with no previous neck, injury or symptom

Sudden onset associated with sudden movement

Treatment initially directed towards opening the affected facet joint