Differential Diagnosis for Occipital Pain, Neck Sprain, and CRP 60

Single Most Likely Diagnosis

• Cervical Spondylosis or Cervical Strain: Given the symptoms of occipital pain and neck sprain, along with an elevated CRP (C-reactive protein) indicating inflammation, a cervical strain or early signs of cervical spondylosis are plausible. These conditions often result from trauma, poor posture, or degenerative changes, leading to inflammation and pain.

Other Likely Diagnoses

• Whiplash Injury: This is a common cause of neck pain and occipital headache following a sudden acceleration-deceleration movement, such as in a car accident. The elevated CRP could indicate the body's inflammatory response to the injury.
• Torticollis: This condition, characterized by a twisted neck, can cause significant pain and stiffness, potentially radiating to the occipital region. Inflammation could contribute to the elevated CRP.
• Cervical Disc Herniation: A herniated disc in the cervical spine can cause pain, especially if it compresses or irritates nearby nerves, potentially leading to occipital pain and elevated inflammatory markers.

Do Not Miss Diagnoses

• Meningitis: Although less likely, meningitis is a critical diagnosis that cannot be missed. It can present with severe headache, neck stiffness, and elevated inflammatory markers. The occipital pain could be part of a broader headache pattern.
• Subarachnoid Hemorrhage: A sudden, severe headache (often described as "the worst headache" ever experienced) can be a sign of a subarachnoid hemorrhage. While the primary symptom is a severe headache, neck pain and stiffness can also occur.
• Cervical Spine Fracture: Especially in the context of trauma, a fracture of the cervical spine must be considered. This condition can lead to significant pain, instability, and potentially life-threatening complications if not promptly addressed.

Rare Diagnoses

• Giant Cell Arteritis: This condition, more common in older adults, involves inflammation of the blood vessels and can cause headaches, including those localized to the occipital region. Elevated CRP is consistent with this diagnosis.
• Occipital Neuralgia: This is a condition characterized by inflammation of the occipital nerves, leading to severe, sharp pain in the occipital region. It could be considered if other diagnoses are ruled out and the pain pattern is consistent with nerve involvement.