Differential Diagnosis

The patient's presentation of reversal of the cervical curvature and minimal narrowing of the C5-C6 intervertebral space can be approached by considering the following categories:

• Single most likely diagnosis
  • Musculoskeletal strain or injury: This is the most likely diagnosis given the reversal of the cervical curvature, which is often seen in cases of muscle spasm or strain. The minimal narrowing of the C5-C6 intervertebral space could be related to a disc injury or early degenerative changes, but in the context of the reversal of curvature, a musculoskeletal issue seems more probable.
• Other Likely diagnoses
  • Cervical spondylosis: This condition involves wear and tear on the discs and joints in the neck, which could explain the minimal narrowing of the C5-C6 intervertebral space. However, it might not fully account for the reversal of the cervical curvature unless there is significant muscle spasm.
  • Herniated disc: A herniated disc at the C5-C6 level could cause narrowing of the intervertebral space and potentially lead to muscle spasm, resulting in the reversal of the cervical curvature.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Cervical spine fracture: Although the vertebral body heights are maintained, a fracture could still be present, especially if it's a non-displaced or hairline fracture. This would be critical to identify to prevent further injury.
  • Spinal infection (e.g., discitis or osteomyelitis): Infections in the spine can cause destruction of the intervertebral disc and adjacent vertebrae, leading to narrowing of the disc space. While less likely, these conditions are serious and require prompt diagnosis and treatment.
  • Cervical spine tumor: Tumors, whether benign or malignant, can affect the cervical spine, causing pain, muscle spasm, and alterations in spinal curvature. Early detection is crucial for effective management.
• Rare diagnoses
  • Rheumatoid arthritis or other inflammatory arthropathies: These conditions can affect the cervical spine, leading to alterations in curvature and disc space narrowing. However, they are less common causes of these specific findings.
  • Klippel-Feil syndrome: A rare congenital condition characterized by the fusion of any two of the seven cervical vertebrae, which could potentially lead to an abnormal cervical curvature. However, this would typically be identified earlier in life.