Differential Diagnosis for Stab to the Back with Loss of Sensation in the Right Side

• Single most likely diagnosis:
  • Spinal cord injury (specifically, a hemisection of the spinal cord, also known as Brown-Séquard syndrome): This condition is characterized by a loss of sensation on one side of the body and is a common consequence of a penetrating trauma like a stab wound to the back.
• Other Likely diagnoses:
  • Thoracic spinal nerve root injury: Damage to the nerve roots in the thoracic spine can cause loss of sensation on one side of the body, depending on the level and severity of the injury.
  • Intercostal nerve injury: The intercostal nerves run between the ribs and can be damaged by a stab wound, leading to loss of sensation in the area they supply.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Aortic injury: A stab wound to the back can potentially damage the aorta, leading to severe bleeding and potentially fatal outcomes if not promptly addressed.
  • Pulmonary injury: The lungs are located in the thoracic cavity and can be damaged by a stab wound, leading to pneumothorax, hemothorax, or other life-threatening conditions.
  • Vertebral artery injury: Although less common, a stab wound to the back can potentially damage the vertebral arteries, leading to stroke or other severe neurological consequences.
• Rare diagnoses:
  • Syringomyelia: A rare condition characterized by the formation of a fluid-filled cavity within the spinal cord, which can cause loss of sensation, but this would be an unlikely direct result of a stab wound.
  • Arachnoiditis: Inflammation of the arachnoid membrane surrounding the spinal cord, which can cause a variety of neurological symptoms, including loss of sensation, but this is more commonly associated with chronic conditions or infections rather than acute trauma.