Differential Diagnosis for Reversal of Cervical Curvature and Minimal Narrowing of C5-C6 Intervertebral Space

• Single Most Likely Diagnosis
  • Cervical Spondylosis: This condition is characterized by wear and tear on the discs and joints in the neck, which can lead to reversal of the cervical curvature and narrowing of the intervertebral spaces, particularly at C5-C6. The symptoms and radiographic findings provided align closely with this common degenerative condition.
• Other Likely Diagnoses
  • Cervical Herniated Disc: A herniated disc at the C5-C6 level could cause narrowing of the intervertebral space and potentially lead to reversal of the cervical curvature due to muscle spasm or structural changes.
  • Cervical Spinal Stenosis: This condition involves narrowing of the spinal canal in the neck, which can be associated with reversal of the cervical lordosis and intervertebral space narrowing, especially if it involves the C5-C6 segment.
  • Trauma: Acute or chronic trauma to the cervical spine could result in these radiographic findings, depending on the nature and severity of the injury.
• Do Not Miss Diagnoses
  • Cervical Spine Fracture: Although less likely, a fracture in the cervical spine could present with these findings, especially if there's an unstable fracture that hasn't significantly displaced. Missing this diagnosis could have severe consequences.
  • Infection (e.g., Discitis or Osteomyelitis): Infections of the spine can cause destruction of the intervertebral disc and adjacent vertebrae, leading to narrowing of the disc space and alteration of the spinal curvature. These conditions require prompt diagnosis and treatment to prevent serious complications.
  • Tumor: Both primary and metastatic tumors can affect the cervical spine, causing destruction of the vertebrae or discs, which might result in the observed radiographic changes. Early detection is crucial for effective management.
• Rare Diagnoses
  • Rheumatoid Arthritis: Although more commonly associated with the hands and feet, rheumatoid arthritis can affect the cervical spine, leading to instability and alterations in spinal curvature.
  • Diffuse Idiopathic Skeletal Hyperostosis (DISH): This condition involves calcification and bony growth along the spine, which can affect the cervical region and potentially cause reversal of the normal lordosis.
  • Ankylosing Spondylitis: A chronic inflammatory disease that can cause the vertebrae to fuse, leading to a rigid spine and loss of the normal cervical lordosis.