Differential Diagnosis for Spinal Cord Injury

The patient's symptoms suggest a specific type of spinal cord injury. Here's a breakdown of the differential diagnosis:

• Single most likely diagnosis

  • Anterior cord syndrome: This condition is characterized by the loss of motor function and the loss of pain and temperature sensation, with preservation of proprioception and vibration. The patient's inability to move distal to T10 and the loss of pain and temperature sensation, along with preserved proprioception and vibration, align with the symptoms of anterior cord syndrome.

• Other Likely diagnoses

  • Brown-Séquard syndrome: Although less likely, this syndrome involves a hemisection of the spinal cord, resulting in ipsilateral loss of motor function and proprioception, and contralateral loss of pain and temperature sensation. The patient's symptoms do not perfectly match this pattern, but it's still a consideration.
  • Central cord syndrome: Typically presents with greater weakness in the upper limbs than the lower limbs, which is not the case here. However, it's still a possible diagnosis if the patient's symptoms evolve or if there are other underlying factors.

• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)

  • Spinal shock: Although not a specific cord syndrome, spinal shock is a condition that can present with rapidly progressing neurological deficits. It's crucial to monitor the patient closely for any signs of worsening neurological function.
  • Epidural hematoma: A potentially life-threatening condition that can cause rapid neurological deterioration. Although the patient's vital signs are currently stable, any signs of worsening neurological function or instability should prompt immediate imaging and possible intervention.

• Rare diagnoses

  • Posterior cord syndrome: This is a rare condition characterized by the loss of proprioception and vibration, with preservation of motor function and pain/temperature sensation. The patient's symptoms do not align with this diagnosis, making it less likely.
  • Other rare spinal cord injuries: Such as conus medullaris syndrome or cauda equina syndrome, which may present with different patterns of neurological deficits. These diagnoses are less likely given the patient's specific symptoms but should be considered if the clinical picture changes or if other factors are present.