Differential Diagnosis for a 70-year-old Male with Normal BP, Cervical Neck Pain, and Headache
- Single most likely diagnosis:
- Cervical spondylosis: This condition is common in older adults and can cause neck pain and headaches due to the wear and tear of the cervical spine.
- Other Likely diagnoses:
- Tension headache: Often associated with neck pain, tension headaches are common and can be exacerbated by poor posture or stress.
- Cervical strain: Muscle strain in the neck can lead to pain and headaches, possibly due to overuse or injury.
- Degenerative disc disease: Similar to cervical spondylosis, this condition affects the discs in the neck, leading to pain and potentially headaches.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Subarachnoid hemorrhage: Although less likely, a sudden onset of severe headache and neck pain could indicate a life-threatening bleed in the brain.
- Cervical artery dissection: A tear in the artery wall in the neck can lead to a stroke, presenting with neck pain and headache.
- Giant cell arteritis: An inflammatory condition affecting the arteries, particularly in older adults, which can cause headaches and neck pain, and if untreated, can lead to blindness or stroke.
- Rare diagnoses:
- Occipital neuralgia: Inflammation of the nerves in the neck can cause sharp, stabbing headaches and neck pain.
- Atlantoaxial subluxation: A rare condition where the joint between the first and second cervical vertebrae becomes unstable, potentially causing neck pain and headaches.
- Neoplastic processes (e.g., metastases to the cervical spine): Although rare, cancer can cause neck pain and headaches, especially in older adults with a history of cancer.