Diagnostic Corollaries Dan Kurth, DC Parker College of Chiropractic Cervical Region

Major/Primary Diagnosis n Cervicocranial Syndrome n Cervical Segmental Dysfunction n for Cervical vertebra, closed n Displacement of cervical IVD, nerve compression- discogenic

Modifying the diagnosis n Patient complains of neck pain n Objective exam shows u Cervical muscles tender u Reduced ROM n Modifying Diagnoses u Myalgia, Myositis u Cervicalgia u Cervical Sprain/strain u Late effects of Cervical Sprain/Strain

Acute Neck Pain with radiation n Objective exam findings: u Pain (radiating) on motion, foramina compression test, Soto Hall test, Cervical distraction test, Sensory testing n Modifying diagnoses u Neuralgia, Neuritis u Cervical radiculitis, non disc related, Brachial radiculitis/Neuritis u Scalenus Anticus Syndrome

Persistent neck pain Pain on motion n Pain, swelling, redness, limited ROM, difficult motion, foramina compression test, Soto Hall test, cervical distraction, sensory testing, muscle strength testing. n Modifying diagnoses u Cervical radiculitis u Cervical spondylosis w/out myelopathy u Neuralgia, Neuritis u Late effects of sprain/strain injury

Headache n Positive nerve trajectory findings, foramina compression test, Soto Hall’s test, cervical distraction. n Cervical muscle tenderness/spasm w/absence of ortho signs n Modifying diagnoses: u Headache, occipital neuralgia u Headache, Migraine u Headache, Tension

Neck Pain With Swelling n Tenderness, cervical ganglia, cold, sweaty or clammy hands, reduced ROM, foramina compression test, Soto Hall’s test, cervical distraction, radial pulses, reflexes, motor & sensory testing.

Modifying diagnoses n Brachial Plexus Lesions, Cervical rib syndrome, Costoclavicular syndrome, Scalenus Anticus syndrome n Cervical root lesions n Cervical Sprain & Strain n Radicular Neuralgia n Compression of Spinal Nerve Root

Neck Pain radiating into lower spine with target pain (lower back) n Cervical pain produces target pain in lower back. No objectivity in low back. Soto Hall’s test, Hyndman’s test n Modifying diagnoses u cervical Sprain/Strain u Radicular neuralgia u Compression of Spinal Nerve root

Radiographic Findings n Spondylosis n Changes in Lordotic curve u Loss of, decreased, increased, reversal of n Displacement of vertebral bodies- Anatomically n Hypertrophic Bone Generation lipping & Spurring n foraminal encroachment n Abnormal Disc Spacing

Osseous Pathology n Cervical arthritis, OA n Kyphosis, acquired/postural n Lordosis, acquired/postural n Degeneration of cervical disc n Narrowing of IVD n Degeneration with myelopathy n Disc calcification, discitis n Vertebral fusion, congenital

Reduced Cervical Motion n Limited ROM, malingering test n Modify diagnosis u Myositis u Polymyositis u Cervical Segmental Dysfunction u Stiffness of spine

Severe Stiff Neck n Muscles contracted, spasm,neck fixed in extreme stress, malingering tests, distraction tests u Spasm of muscle u Torticollis, unspecified u Torticollis, congenital u Polymyositis u Cervicalgia u General symptoms, generalized pain

Stiff & Painful Neck n Cervical pain, swelling, limited ROM, prolonged contractio of cervical musculature, reduced ROM u Cervical Myofascitis u Cervical Spondylosis (acquired) u Cervical Spondylosis (w/out myelopathy

Vertigo with Neck Pain on Motion n Positive Scalenus anticus test, positive spinal accessory nerve test, Adson’s Test, hyperabduction, costoclavicular test u Vertigo (neuropathic) u Scalenus Anticus Syndrome (cervical rib)

Deep Boring Pain n Deep pain localized over a specific vertebra, pain on palpation, percussion tests u Cervical Sprain or Strain u Late Effects Sprain or Strain

Unrelenting Neck Problems, Radicular neuralgia, Neck pain with Insomnia n (+) neuro & ortho findings, Naffziger tests, foramina compressio test, Sprain/strain, hyper-kinesia, visual disturbances,