Neck-to-shoulder pain as an unusual presentation of pulmonary embolism in a patient with cervical spinal cord injury

Lee, Dong Gyu; Lee, Hee Jin

doi:10.1097/md.0000000000008288

Cited by 5 publications

(4 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Damage of this neural tract from SCI can result in neuropathic pain at or below the level of the injury. In our patient, neuropathic pain following SCI occurred in the bilateral occipital regions, which corresponds to the C2 dermatome [6]. The neuropathic pain seemed to have resulted from the injury of the central portion of the spinal cord at the C2-3 level.…”

Section: Discussionmentioning

confidence: 61%

An unusual presentation of neuropathic pain following cervical spinal cord injury: a case report

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background:We report a patient with unusual occipital neuropathic pain (at-level neuropathic pain) due to a small central cervical spinal cord injury (SCI). Case presentation: A 50-year-old man presented with severe bilateral occipital pain after falling from a height of 2 m, 2 weeks ago. The degree of pain was evaluated to be 9 out of 10 using the numeric rating scale (NRS). The nature of the pain was tingling, burning, and piercing, and hyperalgesia was present over the bilateral posterior head regions. Greater occipital nerve block with bupivacaine and dexamethasone was not effective. On axial T2cervical magnetic resonance imaging (MRI), a focal high signal change was observed in the central portion of the spinal cord at the C2 level. We deliberated that the patient's pain was due to the SCI observed on MRI, and after administration of oral medications, the NRS pain score reduced from 9 to 2. Conclusions: Neuropathic pain caused by SCI varies according to the location and degree of injury of the painrelated neural tracts; therefore, clinicians should closely observe the pain patterns and findings on imaging in patients with SCI to determine the cause of pain accurately.

show abstract

Section: Discussionmentioning

confidence: 61%

An unusual presentation of neuropathic pain following cervical spinal cord injury: a case report

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Visceral referred NP is linked to the involvement of the vagus and/or phrenic nerves. The nociceptive input from any of the organs innervated by the vagus nerve sensitizes the trigeminocervical nuclear complex that descends to C3 or C4 levels, and may trigger a headache [67] and/or NP [14]. The phrenic nerve is a motor and sensitive nerve formed by C3-C4 roots, with C5 as an accessory root.…”

Section: Somatic Consequences Of Visceral Disordersmentioning

confidence: 99%

“…Understanding and awareness of referred pain is key for a precise diagnosis of the pain source [14]. Previous evidence shows that gastrointestinal, biliary, renal, hepatic, heart, and pulmonary disorders may evoke referred pain to the upper quadrant of the body, including the neck region [15].…”

Section: Introductionmentioning

confidence: 99%

Visceral Origin: An Underestimated Source of Neck Pain. A Systematic Scoping Review

et al. 2019

View full text Add to dashboard Cite

The diagnosis of neck pain is challenging. Many visceral disorders are known to cause it, and clinical practice guidelines recommend to rule them out during neck pain diagnosis. However, the absence of suspicion of any cause impedes one from establishing that specific aetiology as the final diagnosis. To investigate the degree of consideration given to visceral aetiology, a systematic search of trials about neck pain was carried out to evaluate their selection criteria. The search yielded 309 eligible articles, which were screened by two independent reviewers. The PEDro scale score was used to assess the methodological quality of the studies. The following information was retrieved: number of authors affiliated to a clinical or non-clinical institution, number of citations in the Web of Science, study aims, characteristics of participants, and eligibility criteria. The top 15 most cited trials, and the 15 most recent studies about treatment efficacy in neck pain, published in first quartile journals of the Journal Citation Reports, were selected. Females represented 67.5% of participants. A single study was of poor methodological quality (4/10). Based on the eligibility criteria of the articles that were systematically reviewed, it would appear that visceral aetiology was not considered in eighty percent of the trials on neck pain, showing a low level of suspicion both in research and clinical settings.

show abstract

“…Notably, shoulder pain can be caused by many non-neuro-musculoskeletal disorders [ 3 , 6 , 7 , 8 , 9 ]. In this context, some rare intracranial pathologies, in particular, can affect the shoulder complex in terms of pain and disability [ 6 , 10 ]; they are often characterized by compressive space-occupying masses [ 7 ] and/or ischemia in areas that are functionally connected to the shoulder [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Intracranial Epidermoid Cyst Mimics Musculoskeletal Shoulder Disease: Findings from a Case Report in Physiotherapy Clinical Practice

Brindisino

Lorusso

Mourad

et al. 2022

IJERPH

View full text Add to dashboard Cite

Shoulder pain is often attributable to a musculoskeletal disorder, but in some instances, it may be linked to pathologies outside the physiotherapist’s area of expertise. Specifically, some intracranial problems can cause pain and disability to the shoulder complex. This case report aims to describe the clinical presentation, history taking, physical examination, and clinical decision-making procedures in a patient with an intracranial epidermoid cyst mimicking a musculoskeletal disorder of the shoulder girdle. A 42-year-old man complained of pain and disability in his left shoulder. Sudden, sharp pain was reported during overhead movements, associated with intermittent tingling of the left upper trapezius and left scapular area. Moreover, the patient reported reduced hearing in his left ear and left facial dysesthesia. The physical examination led the physiotherapist to hypothesize a pathology outside the physiotherapist’s scope of practice and to refer the patient to another health professional to further investigate the patient through imaging. It is essential for the physiotherapist to recognize when the patient’s clinical condition requires a referral to another healthcare professional. Therefore, the physiotherapist must be able to, in a timely manner, identify signs and symptoms suggesting the presence of medical pathology beyond his expertise, through appropriate medical history collection and physical evaluation.

show abstract

Neck-to-shoulder pain as an unusual presentation of pulmonary embolism in a patient with cervical spinal cord injury

Cited by 5 publications

References 19 publications

An unusual presentation of neuropathic pain following cervical spinal cord injury: a case report

An unusual presentation of neuropathic pain following cervical spinal cord injury: a case report

Visceral Origin: An Underestimated Source of Neck Pain. A Systematic Scoping Review

Intracranial Epidermoid Cyst Mimics Musculoskeletal Shoulder Disease: Findings from a Case Report in Physiotherapy Clinical Practice

Contact Info

Product

Resources

About