Differential Diagnosis for 87 y/o Female with Confusion and Left Sided Neck Pain
- Single most likely diagnosis
- Cervical spine fracture or osteoporotic compression fracture: Given the patient's age and the sudden onset of neck pain, a fracture is a plausible cause. The confusion could be due to pain, decreased mobility, or other related factors.
- Other Likely diagnoses
- Cervical spondylosis or cervical disc herniation: These conditions can cause neck pain and, if severe, might contribute to confusion due to pain or decreased mobility.
- Musculoskeletal strain: The patient could have strained her neck, leading to pain and potentially confusion if she is not able to move comfortably or is experiencing significant pain.
- Infection (e.g., cervical abscess or epidural abscess): Although less common, infections in the cervical spine area can cause severe pain and confusion due to systemic illness.
- Do Not Miss diagnoses
- Stroke or transient ischemic attack (TIA): The combination of confusion and neck pain could be indicative of a stroke, especially if the pain is related to dissection of the carotid artery. This is a medical emergency.
- Carotid artery dissection: This condition can cause neck pain and, if it leads to a stroke, confusion. It's critical to diagnose promptly.
- Meningitis: Although the presentation might be atypical in the elderly, meningitis can cause neck pain and confusion. It requires immediate medical attention.
- Rare diagnoses
- Temporomandibular joint (TMJ) disorder: While less likely, TMJ disorders can cause pain that radiates to the neck and, in severe cases, might contribute to confusion due to pain.
- Eagle syndrome (elongated styloid process): This rare condition can cause neck pain but is less likely to be associated with confusion unless it leads to significant distress or another complication.
- Rheumatologic conditions (e.g., polymyalgia rheumatica, giant cell arteritis): These conditions can cause neck pain and, in some cases, confusion due to systemic inflammation or associated conditions like temporal arteritis.