Differential Diagnosis for C5-6 Neuralgia in a 34-Year-Old
Single Most Likely Diagnosis
- Cervical Disc Herniation: This is the most common cause of C5-6 neuralgia, especially in a young adult. The herniated disc can compress the C6 nerve root, leading to pain, numbness, and weakness in the affected arm.
Other Likely Diagnoses
- Cervical Spondylosis: Wear and tear on the cervical spine can cause neuralgia, especially if there is foraminal stenosis or osteophyte formation compressing the C6 nerve root.
- Cervical Facet Joint Syndrome: Inflammation or injury to the facet joints in the cervical spine can cause referred pain to the arm, mimicking neuralgia.
- Thoracic Outlet Syndrome: Compression of the brachial plexus or subclavian artery can cause pain, numbness, and weakness in the arm, which may be referred to the C5-6 distribution.
Do Not Miss Diagnoses
- Spinal Cord Compression: Although less likely, spinal cord compression due to a tumor, abscess, or hematoma can cause neuralgia and should be ruled out to avoid serious consequences.
- Infectious or Inflammatory Conditions: Conditions like osteomyelitis, discitis, or epidural abscess can cause neuralgia and require prompt treatment to prevent serious complications.
- Vascular Conditions: Vascular malformations or aneurysms can compress the nerve roots, causing neuralgia, and should be considered in the differential diagnosis.
Rare Diagnoses
- Neurogenic Tumors: Tumors like schwannomas or neurofibromas can compress the C6 nerve root, causing neuralgia.
- Cervical Spine Fracture or Instability: Traumatic injuries can cause instability or fracture of the cervical spine, leading to neuralgia.
- Autoimmune Disorders: Conditions like multiple sclerosis or rheumatoid arthritis can cause neuralgia, although they are less common causes of C5-6 neuralgia.