Neck pain

i. Exclude meningitis (neck pain + fever)

Examination for meningitis

  • Meningitis (medical emergency)

ii. Exclude recent accident involving the neck

History

  • Muscle spasm (neck pain may gradually increase over the course of several hours)

  • Spinal cord injury (neck pain or numbness referred to the arms - neurological examination)

iii. Exclude past history of whiplash type injury

History

  • Degenerative cervical arthritis (patients with whiplash type injury are 6 times more prone to develop arthritis)

iv. Exclude herniated disk

No history of accidents, referred to the arm/ shoulder
- X-ray

  • Herniated disk (gradual onset)

v. Neck pain tenderness in cervical vertebrae

Request X-ray, CT, MRI to the neck

  • Bone metastasis

vi. Neck pain without abnormality on examination

Request X-ray, CT, MRI to the neck

  • Muscle spasm
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