Differential Diagnosis
- Single most likely diagnosis:
- Osteoporosis: The patient has a history of a T8 compression fracture, and the current imaging shows bony demineralization and mild wedging of the T8 vertebra. This, combined with chronic neck pain and degenerative changes in the cervical spine, suggests osteoporosis as the most likely diagnosis.
- Other Likely diagnoses:
- Cervical spondylosis: The patient has mild degenerative changes in the cervical spine, including endplate spurring and disc narrowing at C6-C7, which is consistent with cervical spondylosis.
- Uncovertebral osteoarthritis: The patient has minor encroachment on bilateral C5-C6 and C6-C7 neural foramina secondary to uncovertebral osteoarthritis, which could be contributing to the patient's neck pain and restricted range of motion.
- Degenerative disc disease: The patient has moderate disc narrowing at C6-C7, which is consistent with degenerative disc disease.
- Do Not Miss diagnoses:
- Spinal infection (e.g., osteomyelitis, discitis): Although less likely, spinal infection could present with similar symptoms and imaging findings, and would require prompt treatment to prevent serious complications.
- Spinal tumor: A spinal tumor could cause compression fractures, degenerative changes, and neurological symptoms, and would require urgent evaluation and treatment.
- Multiple myeloma: This is a type of blood cancer that can cause bony demineralization, compression fractures, and other symptoms similar to those presented by the patient.
- Rare diagnoses:
- Klippel-Feil syndrome: The patient has congenital fusion of C3 and C4 vertebrae, which is a characteristic feature of Klippel-Feil syndrome, a rare congenital disorder.
- Diffuse idiopathic skeletal hyperostosis (DISH): Although the patient has some degenerative changes, the presence of bony demineralization and mild wedging of the T8 vertebra could also be seen in DISH, a rare condition characterized by abnormal bone growth and calcification.