Epidemiology, Diagnosis, and Treatment of Neck Pain

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Epidemiology, Diagnosis, and Treatment of Neck Pain Steven P. Cohen, MD Mayo Clinic Proceedings Volume 90, Issue 2, Pages 284-299 (February 2015) DOI: 10.1016/j.mayocp.2014.09.008 Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 T2-weighted sagittal magnetic resonance image acquired slightly lateral to midline in a patient with unilateral radicular pain demonstrates a disk-osteophyte complex at C5-6 (arrow), which contributes to neural foraminal narrowing. Mayo Clinic Proceedings 2015 90, 284-299DOI: (10.1016/j.mayocp.2014.09.008) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 T2-weighted sagittal magnetic resonance image demonstrating multilevel disk bulging spanning levels C3-4 to C7-T1 causing central spinal stenosis in a patient with neuropathic pain extending into both arms. Ligamentum flavum hypertrophy at C5-6 (arrow A) and low-grade retrolisthesis of C4 on C5 (arrow B) contribute to central spinal stenosis. Note the absence of spinal cord signal hyperintensity, suggesting that there is no active cord edema. Mayo Clinic Proceedings 2015 90, 284-299DOI: (10.1016/j.mayocp.2014.09.008) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 T2-weighted sagittal magnetic resonance image in a patient with signs of myelopathy demonstrating a large central disk extrusion at C5-6. The signal hyperintensity within the spinal cord (arrow) indicates edema. Mayo Clinic Proceedings 2015 90, 284-299DOI: (10.1016/j.mayocp.2014.09.008) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 4 T1-weighted sagittal magnetic resonance image in a patient with a known primary malignant neoplasm demonstrating hypointense lesions within the C3 (arrow A) and T3 (arrow B) vertebral bodies. At T3, there is an accompanying compression fracture with loss of vertebral body height. Breast, lung, prostate, renal cell, and gastrointestinal tract cancers, lymphoma, and melanoma are the primary malignant neoplasms most likely to metastasize to the vertebral bodies and should be considered in the differential diagnosis of a vertebral body infiltrative lesion in patients older than 40 years of age. Mayo Clinic Proceedings 2015 90, 284-299DOI: (10.1016/j.mayocp.2014.09.008) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions