Differential Diagnosis
- Single most likely diagnosis:
- Muscle strain: The patient's sudden onset of pain in the interior left side of the neck around the scalene muscles after a sudden twisting move and hyperextension is consistent with a muscle strain. The presence of slight swelling on the left side of the scalene further supports this diagnosis.
- Other Likely diagnoses:
- Cervical facet joint injury: The patient's history of a motor vehicle accident and subsequent neck pain, combined with the new onset of pain after a sudden movement, could also suggest a cervical facet joint injury.
- Disc herniation: Although less likely given the absence of neurological signs or symptoms, a disc herniation could still be considered, especially given the patient's history of a motor vehicle accident.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Vertebral artery dissection (VAD): Although the patient's presentation is not typical for VAD, the sudden onset of neck pain after a twisting movement, combined with the presence of swelling, warrants consideration of this potentially life-threatening condition.
- Carotid artery dissection: Similar to VAD, carotid artery dissection is a rare but potentially deadly condition that could present with neck pain and swelling, and should be considered in the differential diagnosis.
- Rare diagnoses:
- Spontaneous hematoma: A spontaneous hematoma in the neck could present with sudden onset of pain and swelling, although this would be a rare occurrence.
- Thoracic outlet syndrome: Although less likely given the patient's presentation, thoracic outlet syndrome could be considered as a rare diagnosis, especially if the patient's symptoms are exacerbated by certain movements or positions.