Neck Pain

Question 1

Cervical Radiculopathy
- imaging is not required to confirm

1/ When may imaging be considered?

Answer 1

1/ Consider MRI if c/radiculpathy has been present for 6/52

MRI is suggested for patients who have failed a course of conservative therapy and who may be candidates for interventional or surgical treatment.

Question 2

When may cervical xrays performed?

Answer 2

deltoid weakness
scapular winging
weakness of the intrinsic muscle of the hand, chest, deep breast pain
headaches

Question 3

DDx for neck pain:

Answer 3

V - vascular insufficency, Carotid artery dissection
I - Infection (retropharyngeal abcess) / other meningism
N - Neoplasm (lymphma)
D
I
C
A - Autoimmune disease e.g. RA (causing atlanto axial disruption)
T - Trauma
E
S

Neurological - somatic pain (spondylysis-osteoarthritis, discogenic, facet joint pain) / cervical radiculopathy, cervical stenosis causing gait disturbance, loss of vibration sense, clumpsy hands)
Cardiac - referred pain from AMI
Resp
MSK - whiplash

Question 4

Red flags

Answer 4

Trauma (e.g. mva, osteoporotic patient) 
History of rheumatoid arthritis 
Infective sx (meningism, IVDU, immunocomprimised) 
Neoplasm history
Ripping or tearing sensation 
Focal Neurology 
SOB, Chest pain sx 

Age >50yrs with new sx 
Systemic sx 
Mod to severe neck pain for 6/52
Neurological findings
History of malignancy