2017
DOI: 10.1097/md.0000000000008288
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Neck-to-shoulder pain as an unusual presentation of pulmonary embolism in a patient with cervical spinal cord injury

Abstract: Rationale:Information on referred pain can be helpful for diagnosing diseases of the visceral organs. Here, the authors report a patient with cervical spinal cord injury (SCI) who had referred pain at the right side from the neck to shoulder, as a presentation of pulmonary embolism (PE).Patient concerns:A 55-year-old man with complete tetraplegia, due to cervical SCI after C5 and C6 vertebral body fracture, complained of right neck-to-shoulder pain (numerical scale rating: 6). Despite pain medication (meloxica… Show more

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Cited by 5 publications
(4 citation statements)
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“…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%
“…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%
“…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%
“…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%