A 19-year-old male who regularly performs weight lifting (weightlifting) complains of neck pain, particularly upon neck extension, which is associated with tingling in his left arm.

Differential Diagnosis for Neck Pain and Tingling in the Left Arm

Single Most Likely Diagnosis

• Cervical Spondylosis or Cervical Disc Herniation: This condition is likely due to the patient's history of weightlifting, which can put strain on the neck and lead to disc herniation or spondylosis. The symptoms of neck pain, especially on extension, and tingling in the left arm are consistent with cervical radiculopathy.

Other Likely Diagnoses

• Cervical Strain or Sprain: Weightlifting can cause muscle strain or sprain in the neck, leading to pain and stiffness, especially with certain movements like extension.
• Thoracic Outlet Syndrome: This condition involves compression of the nerves and/or blood vessels that pass through the thoracic outlet, which can cause neck pain, arm tingling, and weakness.
• Cervical Facet Joint Pain: The facet joints in the neck can become inflamed or irritated, causing pain and stiffness, especially with extension.

Do Not Miss Diagnoses

• Spinal Cord Injury or Compression: Although less likely, it is crucial to rule out spinal cord injury or compression, which can cause permanent damage if not promptly addressed.
• Cervical Spinal Stenosis: Narrowing of the spinal canal in the neck can cause compression of the spinal cord, leading to pain, numbness, and tingling in the arms.
• Multiple Sclerosis: This autoimmune disease can cause a wide range of neurological symptoms, including numbness, tingling, and pain in the arms.

Rare Diagnoses

• Cervical Osteochondroma: A rare benign tumor that can cause compression of the spinal cord or nerves, leading to pain and numbness in the arms.
• Infectious or Inflammatory Conditions: Such as osteomyelitis, discitis, or abscesses, which can cause neck pain and stiffness, although these are less common in a young, otherwise healthy individual.
• Vascular Conditions: Such as vertebral artery dissection or subclavian artery thrombosis, which can cause neck pain and arm symptoms, although these are rare and often associated with other symptoms like headache or visual disturbances.