Neck Flashcards
What are the safety considerations/precautions and serious conditions for acute neck pain?
Neck pain associated with
- trauma - > fracture
- infection -> meningitis, osteomyelitis, sinusitis
- headache + fever -> meningitis
- progressive neurological symptoms
- night pain, malaise, night sweats, positional pain
- CAD symptoms (vertebral or carotid aneurysm)
- anticoagulant use
- long term steroid use
- cardinal signs and symptoms -> myelopathy
What are the Red flags for acute neck pain
- progressively worsening
- progressive neurological symptoms
- severe trauma
- severe worsening pain
- night pain
- headache + neck pain + nausea/fever
- severe sudden onset
- unexplained weight loss, fatigue, loss of appetite and memory
- History of cancer
What are red flags for acute neck pain related to tumors?
Red flags include a past history of malignancy, age over 50 years, failure to improve with treatment, and unexplained weight loss.
What are red flags for acute neck pain related to fractures?
History of trauma and use of corticosteroids are significant indicators.
What serious disorders should not be missed ?
- CAD, Myocardial ischaemia, angina, subarachnoid intracranial haemorrhage
- neoplasia - primary or metastasis
- severe infection - osteomyelitis and meningitis
What does VINDICATE stand for and what is it used for ?
V - vascular/visceral
I - infection/inflammatory
N - neoplasia
D - degenerative
I - idiopathic/iatrogen
C - congenital
A - autoimmune
T - Trauma
E - Endocrine/metabolic
It helps clinicians systematically evaluate potential causes of neck pain, ensuring no major condition is over looked
What are red flags for vertebral or carotid aneurysm?
Cardiovascular risk factors and transient ischemic attacks are important to consider.
What are the three most common causes of neck pain?
- Vertebral joint dysfunction 2. Musculoligamentous strains and sprains 3. Cervical spondylosis (OA of spine).
What disorders are often missed in neck pain diagnosis?
Disorders include radiculopathy, myelopathy, thoracic outlet syndrome, cervical lymphadenitis, psychogenic conditions, and various rheumatological disorders.
What is the LSVS mnemonic used for?
It is a mnemonic for the location of pathology: L - Local, S - somatic referred, V - Visceral referred, S - Systemic.
What is somatic pain in relation to neck pain?
Somatic pain is non-specific neck pain, often without a definitive pathoanatomical diagnosis.
What is cervical facet pain?
Cervical facet pain arises from the facet joint capsules, which are innervated by cervical dorsal rami and can be affected by traumatic or degenerative processes.
What are the associated features of cervical facet pain?
Features include localized unilateral tenderness, muscle spasms, and neck stiffness.
What is cervical discogenic pain?
Cervical discs and facets are innervated by the same spinal segment, making it difficult to determine the source of nociception.
What are the types of disc pathology?
Types include normal, disc bulge, herniation (protrusion or extrusion), sequestration, annular fissure, and degenerative disc disease.
What is cervical radiculopathy?
Cervical radiculopathy refers to irritation, compression, or dysfunction of one or more cervical nerve roots, often due to disc pathology or spondylosis.
What is cervical myelopathy?
Cervical myelopathy is a serious condition arising from cervical cord compression, commonly caused by cervical spondylosis.
What are the clinical features of cervical myelopathy?
Features include insidious onset of symptoms, hypersensitivity, clumsiness, tightness in the legs, and UMN signs below the lesion.
What is whiplash associated disorder (WAD)?
WAD is caused by an acceleration-deceleration mechanism of energy transfer to the neck region.
What are the associated symptoms of WAD?
Symptoms can include tinnitus, visual problems, TMJ pain, and psychological issues such as depression and anxiety.
What is thoracic outlet syndrome?
Thoracic outlet syndrome involves the entrapment of neurovascular structures as they pass from the neck to the axilla.
What are the most common sites of compression in thoracic outlet syndrome?
Common sites include the costoclavicular space, pectoralis minor muscle, and between the scalene muscles.
What is the EAST Test?
The EAST Test (Elevation Arm Stress Test) is a special test used to evaluate thoracic outlet syndrome.
