Differential Diagnosis for Arm Tingling and Pain Secondary to C4-C5 Neural Foraminal Narrowing
Single Most Likely Diagnosis
- Cervical Radiculopathy: This condition is the most likely diagnosis given the symptoms of arm tingling and pain secondary to C4-C5 neural foraminal narrowing. The narrowing of the neural foramen at the C4-C5 level can compress the nerve root, leading to radiculopathy, which manifests as pain, tingling, and sometimes weakness in the arm.
Other Likely Diagnoses
- Cervical Spondylosis: This condition involves wear and tear on the discs and joints in the neck, which can lead to foraminal narrowing and subsequent nerve root compression, causing arm tingling and pain.
- Herniated Cervical Disc: A herniated disc at the C4-C5 level can compress the nerve root, leading to symptoms of radiculopathy, including arm tingling and pain.
- Cervical Stenosis: Narrowing of the cervical spinal canal can also compress the spinal cord or nerve roots, leading to symptoms such as arm tingling and pain.
Do Not Miss Diagnoses
- Spinal Cord Compression: Although less likely, spinal cord compression due to severe cervical stenosis or a large disc herniation can present with arm tingling and pain and is a medical emergency.
- Cervical Fracture or Instability: Traumatic injuries can cause cervical fractures or instability, leading to neural foraminal narrowing and nerve root compression, which requires immediate medical attention.
- Infection (e.g., Abscess or Osteomyelitis): Infections in the cervical spine can cause destruction of the bone and soft tissues, leading to neural foraminal narrowing and nerve root compression.
- Tumor (e.g., Metastasis or Primary Bone Tumor): Tumors in the cervical spine can cause compression of the nerve roots, leading to arm tingling and pain.
Rare Diagnoses
- Thoracic Outlet Syndrome: Although more commonly associated with compression of the brachial plexus at the thoracic outlet, it can occasionally present with arm tingling and pain.
- Multiple Sclerosis: A demyelinating disease that can affect the spinal cord and present with a wide range of neurological symptoms, including arm tingling and pain.
- Vitamin B12 Deficiency: Can cause neurological symptoms, including tingling and pain in the arms, although this would not be directly related to C4-C5 neural foraminal narrowing.