Differential Diagnosis

The patient presents with neck pain, recent mild headaches, and arm/leg soreness, which started after a specific incident at work. The following differential diagnoses are considered:

• Single most likely diagnosis:
  • Mechanical Neck Pain: This is the most likely diagnosis given the patient's history of neck pain starting after moving their head up and down, worsening with movement, and improving with rest. The tenderness in cervical muscles and reduced ROM in the cervical spine also support this diagnosis.
• Other Likely diagnoses:
  • Cervical Strain: The patient's occupation involves movement and occasional heavy lifting, which could lead to cervical strain. The symptoms of neck pain, stiffness, and limited mobility are consistent with this diagnosis.
  • Cervicogenic Headache: The patient's recent mild headaches associated with neck pain suggest a possible cervicogenic headache, which is a type of headache caused by referred pain from the cervical spine.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
  • Cervical Spine Fracture: Although the patient does not report any significant trauma, a cervical spine fracture could be a possible cause of neck pain, especially if the patient had a recent fall or injury.
  • Spinal Cord Compression: This is a serious condition that requires prompt attention. Although the patient does not report any significant neurological symptoms, spinal cord compression could cause neck pain, numbness, or weakness in the arms or legs.
  • Meningitis: Although the patient does not report any fever, headache, or stiff neck, meningitis is a potentially life-threatening condition that requires prompt diagnosis and treatment.
• Rare diagnoses:
  • Cervical Disc Herniation: Although the patient's symptoms could be consistent with a cervical disc herniation, this diagnosis is less likely given the patient's age and lack of significant neurological symptoms.
  • Rheumatological Disorders: Conditions such as rheumatoid arthritis or ankylosing spondylitis could cause neck pain and stiffness, but these diagnoses are less likely given the patient's age and lack of other systemic symptoms.