Cervical Spine Syndrome: Or something else? Differential Diagnosis

Respiratory System (J00-J99).

Cardiovascular system (I00-I99)

  • Angina pectoris (“chest tightness”; sudden onset of pain in the heart area).
  • Aortic aneurysm – bulging of the wall of the aorta (main artery).
  • Myocardial infarction (heart attack)
  • Dissection of the vertebral artery/internal carotid artery – splitting of the wall layers of the vertebral artery/carotid artery.
  • Epidural hemotoma – hemorrhage in the peridural space with compression of the spinal cord.
  • Spontaneous subarachnoid hemorrhage (SAB; hemorrhage between the spinal meninges and the soft meninges; incidence: 1-3%); symptomatology: proceed according to “Ottawa rule for subarachnoid hemorrhage”:
    • Age ≥ 40 years
    • Meningismus (symptom of painful neck stiffness in irritation and disease of the meninges).
    • Syncope (brief loss of consciousness) or impaired consciousness (somnolence, sopor and coma).
    • Onset of cephalgia (headache) during physical activity.
    • Thunderclap headache/destructive headache (about 50% of cases).
    • Restricted mobility of the cervical spine (Cervical spine).
  • Thoracic outlet syndrome (TOS, synonyms: upper thoracic aperture narrowing syndrome (upper and lower opening of the chest) or shoulder girdle compression syndrome) – temporary or permanent compression of a vascular nerve bundle (consisting of brachial plexus (“brachial plexus”), subclavian artery (subclavian artery), and subclavian vein); symptomatology depends on the cause and location of the narrowing. Circulatory disturbances may occur, as well as sensory disturbances and paralysis of the arm, which in the early stages are usually position-dependent.

Mouth, esophagus (esophagus), stomach and intestines (K00-K67; K90-K93).

  • Esophageal (food pipe) disorders, unspecified.

Musculoskeletal system and connective tissue (M00-M99).

  • Ankylosing spondylitis (ankylosing spondylitis) – chronic inflammatory rheumatic disease that affects only the spine and its border joints.
  • Arthritis (pseudogout) of the lateral atlantoaxial joint (elderly patients).
  • Arthritis psoriatica – joint inflammation that occurs in the context of psoriasis.
  • Osteoarthritis
  • Intervertebral disc prolapse (herniated disc)
  • Foraminastenosis – narrowing of the intervertebral holes through which nerve fibers pass.
  • Osteochondrosis of the spine – degenerative changes of the bone / cartilage in the area of the joints and epiphyses (joint ends with bone core), characterized by sclerosis (calcification) and irregular contouring.
  • Reactive arthritis (synonym: postinfectious arthritis / joint inflammation) – secondary disease after gastrointestinal (gastrointestinal tract concerning), urogenital (urinary and genital organs concerning) or pulmonary (lungs concerning) infections; refers to an arthritis, where pathogens in the joint (usually) can not be found (sterile synovialitis).
  • Reiter’s disease (synonyms: Reiter’s syndrome; Reiter’s disease; arthritis dysenterica; polyarthritis enterica; postenteritic arthritis; posturethritic arthritis; undifferentiated oligoarthritis; urethro-oculo-synovial syndrome; Fiessinger-Leroy syndrome; English Sexually acquired reactive arthritis (SARA)) – special form of a “reactive arthritis” (see above. ); secondary disease after gastrointestinal or urogenital infections, characterized by the symptoms of Reiter’s triad; seronegative spondyloarthropathy, which is triggered especially in HLA-B27 positive persons by an intestinal or urinary tract disease with bacteria (mostly chlamydia); Can manifest as arthritis (joint inflammation), conjunctivitis (conjunctivitis), urethritis (urethritis) and partly with typical skin changes.
  • Rheumatoid arthritis – inflammatory multisystem disease, which usually manifests itself in the form of synovitis (inflammation of the synovial membrane). It predominantly affects the joints, more rarely other organs such as eyes and skin.
  • Shoulder-arm syndrome (neck-shoulder-arm syndrome; cervicobrachialgia) – multifactorial symptom complex; most frequent causes are myofascial (“affecting the muscles and fascia”) complaints, for example due to myogelosis (muscle hardening) or muscle imbalance of the cervical spine; Other causes are degenerative phenomena of the cervical spine (osteochondrosis, spondylarthrosis), shoulder diseases (impingement syndrome, frozen shoulder, omarthrosis, ACG arthrosis, rotator cuff lesion) and internal diseases (lung diseases, diseases of the gallbladder, liver and spleen, and rheumatological diseases). Note: Persistent complaints, especially with neurological deficits, should also think of a spinal or neuroforaminal stenosis (narrowing of the spinal canal / channel along the spine) or a herniated disc (herniated disc).
  • Septic arthritis (inflammation of the joints).
  • Spondyloarthrosis – Degenerative changes in the spine (here the vertebral arch joints), ie a wear disease (osteoarthritis) of the intervertebral joints.
  • Synovial cyst – cyst containing synovial fluid (synovial fluid).
  • Torticollis (obliquity of the head), acute – change in obliquity due to enormous muscle hard not possible; occurrence usually after getting up in the morning or abrupt movements.
  • Cervical discectitis – inflammation of an intervertebral disc in the cervical spine area.
  • Cervical osteomyelitis – inflammation of bone marrow in the cervical spine.

Neoplasms – tumor diseases (C00-D48).

  • Pancoast tumor (synonym: apical sulcus tumor) – rapidly progressive peripheral bronchial carcinoma in the region of the apex of the lung (apex pulmonis); rapidly spreading to the ribs, soft tissues of the neck, brachial plexus (ventral branches of the spinal nerves of the last four cervical and first thoracic segments (C5-Th1)), and vertebrae of the cervical and thoracic spine (cervical spine, thoracic spine)); disease often manifests with a characteristic pancoast syndrome: shoulder or Arm pain, rib pain, paresthesia (sensory disturbances) in the forearm, paresis (paralysis), hand muscle atrophy, upper influence congestion due to constriction of the jugular veins, Horner’s syndrome (triad associated with miosis (pupil constriction), ptosis (drooping of the upper eyelid) and pseudoenophthalmos (apparently sunken eyeball)).
  • Neoplasms, unspecified

Psyche – nervous system (F00-F99; G00-G99)