Causes of Ankylosing Spondylitis
Ankylosing Spondylitis Causes: Book Excerpts
Ankylosing Spondylitis as a complication of other conditions:
Other conditions that might have
Ankylosing Spondylitis as a complication may,
potentially, be an underlying cause of Ankylosing Spondylitis.
Our database lists the following as having
Ankylosing Spondylitis as a complication of that condition:
Ankylosing Spondylitis as a symptom:
Conditions listing Ankylosing Spondylitis
as a symptom may also be potential underlying causes of Ankylosing Spondylitis.
Our database lists the following as having
Ankylosing Spondylitis as a symptom of that condition:
Related information on causes of Ankylosing Spondylitis:
As with all medical conditions,
there may be many causal factors.
Further relevant information on causes of Ankylosing Spondylitis may be found in:
Causes of Ankylosing Spondylitis: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the causes of Ankylosing Spondylitis.
Neck Stiffness/Pain:
Differential Diagnosis
(In a Page: Signs and Symptoms)
- Trauma
–Paraspinal neck stiffness: Commonly due to motor vehicle collisions (“whiplash”) or abnormal sleep posture
–Cervical spine fracture with spasm of neck muscles
–Subarachnoid hemorrhage: Most commonly due to ruptured cerebral aneurysm
–Epidural hematoma
–SCIWORCA: Spinal Cord Injury Without Radiographic Abnormality occurs in pediatric patients with ligamentous laxity and hypermobility of the cervical spine
–Rotary atlantoaxial subluxation: Subluxation of the cervical spine at C1-C2 level, resulting in sternocleidomastoid spasm with tilting of the head toward the affected side and chin pointed toward the ipsilateral side
- Infection
–Meningitis: Often bacterial (e.g., Neisseria meningitidis, Streptococcus pneumoniae) or viral (e.g., HIV, Epstein-Barr virus, enterovirus, herpes simplex virus)
–Cervical lymphadenitis
–Tonsillopharyngitis
–Epiglottitis
–Retropharyngeal abscess
–Epidural abscess
–Discitis
-
Torticollis: Idiopathic sternocleidomastoid spasm, resulting in tilting of the head toward the affected side with the chin pointed to the contralateral side
-
Inflammatory
–Rheumatoid arthritis
–Ankylosing spondylitis
–Degenerative joint disease
-
Tumors (especially leptomeningeal metastases)
-
Dystonic reaction: Idiosyncratic drug reaction, often to psychiatric medications (e.g., haloperidol, prochlorperazine)
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Neck pain:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Ankylosing spondylitis
Intermittent, moderate to severe neck pain and stiffness with a severely restricted range of motion (ROM) is characteristic of ankylosing spondylitis. Intermittent low back pain and stiffness and arm pain are generally worse in the morning or after periods of inactivity and are usually relieved after exercise. Related findings also include a low-grade fever, limited chest expansion, malaise, anorexia, fatigue and, occasionally, iritis.
Cervical extension injury
Anterior or posterior neck pain may develop within hours or days following a whiplash injury. Anterior pain usually diminishes within several days, but posterior pain persists and may even intensify. Associated findings include tenderness, swelling and nuchal rigidity, arm or back pain, an occipital headache, muscle spasms, visual blurring, and unilateral miosis on the affected side.
Cervical spine fracture
Fracture at C1 to C4 can cause sudden death; survivors may experience severe neck pain that restricts all movement, an intense occipital headache, quadriplegia, deformity, and respiratory paralysis.
Cervical spine tumor
Metastatic tumors typically produce persistent neck pain that increases with movement and isn’t relieved by rest; primary tumors cause mild to severe pain along a specific nerve root. Other findings depend on the lesions and may include paresthesia, arm and leg weakness that progresses to atrophy and paralysis, and bladder and bowel incontinence.
Cervical spondylosis
Cervical spondylosis is a degenerative process that produces posterior neck pain that restricts movement and is aggravated by it. Pain may radiate down either arm and may accompany paresthesia, weakness, and stiffness.
Esophageal trauma
An esophageal mucosal tear or a pulsion diverticulum may produce mild neck pain, chest pain, edema, hemoptysis, and dysphagia.
Herniated cervical disk
A herniated cervical disk characteristically causes variable neck pain that restricts movement and is aggravated by it. It also causes referred pain along a specific dermatome, paresthesia and other sensory disturbances, and arm weakness.
Laryngeal cancer
Neck pain that radiates to the ear develops late in laryngeal cancer. The patient may also develop dysphagia, dyspnea, hemoptysis, stridor, hoarseness, and cervical lymphadenopathy.
Lymphadenitis
With lymphadenitis, enlarged and inflamed cervical lymph nodes cause acute pain and tenderness. A fever, chills, and malaise may also occur.
Meningitis
Neck pain may accompany characteristic nuchal rigidity. Related findings include a fever, a headache, photophobia, positive Brudzinski’s and Kernig’s signs, and a decreased level of consciousness (LOC).
Neck sprain
Minor sprains typically produce pain, slight swelling, stiffness, and restricted ROM. Ligament rupture causes pain, marked swelling, ecchymosis, muscle spasms, and nuchal rigidity with head tilt.
Rheumatoid arthritis
Rheumatoid arthritis usually affects peripheral joints, but it can also involve the cervical vertebrae. Acute inflammation may cause moderate to severe pain that radiates along a specific nerve root; increased warmth, swelling, and tenderness in involved joints; stiffness, restricting ROM; paresthesia and muscle weakness; low-grade fever; anorexia; malaise; fatigue; and possible neck deformity. Some pain and stiffness remain after the acute phase.
Spinous process fracture
A fracture near the cervicothoracic junction produces acute pain radiating to the shoulders. Associated findings include swelling, exquisite tenderness, restricted ROM, muscle spasms, and deformity.
Subarachnoid hemorrhage
Subarachnoid hemorrhage is a life-threatening condition that may cause moderate to severe neck pain and rigidity, a headache, and a decreased LOC. Kernig’s and Brudzinski’s signs are present. The patient may describe the headache as, “the worst headache of my life.”
Thyroid trauma
Besides mild to moderate neck pain, thyroid trauma may cause local swelling and ecchymosis. If a hematoma forms, it can cause dyspnea.
Torticollis
Torticollis is a neck deformity in which severe neck pain accompanies recurrent unilateral stiffness and muscle spasms that produce a characteristic head tilt.
Tracheal trauma
A fracture of the tracheal cartilage, a life-threatening condition, produces moderate to severe neck pain and respiratory difficulty.
Torn tracheal mucosa produces mild to moderate pain and may result in airway occlusion, hemoptysis, hoarseness, and dysphagia.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Ankylosing spondylitis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Evidence strongly suggests a familial tendency in ankylosing spondylitis. The presence of human leukocyte antigen (HLA)-B27 (positive in more than 90% of patients with this disease) and circulating immune complexes suggests immunologic activity.
One out of 10,000 people has ankylosing spondylitis. It affects more males than females and usually emerges between ages 20 and 40, although it may develop in children younger than age 10.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Juvenile rheumatoid arthritis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
The cause of JRA remains puzzling. Research continues to test several theories, such as those linking the disease to genetic factors or to an abnormal immune response. Viral or bacterial (particularly streptococcal) infection, trauma, and emotional stress may be precipitating factors, but their relationship to JRA remains unclear.
Considered the major chronic rheumatic disorder of childhood, JRA affects an estimated 150,000 to 250,000 children in the United States; overall incidence is twice as high in females, with variation among the types of JRA.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Rheumatoid arthritis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
RA occurs worldwide, striking three times more females than males. Although it can occur at any age, it begins most often between ages 25 and 55. This disease affects more than 7 million people in the United States alone.
What causes the chronic inflammation characteristic of RA isn’t known, but various theories point to infectious, genetic, and endocrine factors. Currently, it’s believed that a genetically susceptible individual develops abnormal or altered immunoglobulin (Ig) G antibodies when exposed to an antigen. This altered IgG antibody isn’t recognized as “self,” and the individual forms an antibody against it — an antibody known as RF. By aggregating into complexes, RF generates inflammation. Eventually, cartilage damage by inflammation triggers additional immune responses, including activation of complement. This in turn attracts polymorphonuclear leukocytes and stimulates release of inflammatory mediators, which enhance joint destruction.
Much more is known about the pathogenesis of RA than about its causes. If unarrested, the inflammatory process within the joints occurs in four stages. First, synovitis develops from congestion and edema of the synovial membrane and joint capsule. Formation of pannus — thickened layers of granulation tissue — marks the second stage’s onset. Pannus covers and invades cartilage and eventually destroys the joint capsule and bone. Progression to the third stage is characterized by fibrous ankylosis — fibrous invasion of the pannus and scar formation that occludes the joint space. Bone atrophy and malalignment cause visible deformities and disrupt the articulation of opposing bones, causing muscle atrophy and imbalance and, possibly, partial dislocations or subluxations. In the fourth stage, fibrous tissue calcifies, resulting in bony ankylosis and total immobility.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Neck pain:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Ankylosing spondylitis
Intermittent, moderate to severe neck pain and stiffness with severely restricted range of motion is characteristic of this disorder. Intermittent low back pain and stiffness and arm pain are generally worse in the morning or after periods of inactivity and are usually relieved after exercise. Related findings also include low-grade fever, limited chest expansion, malaise, anorexia, fatigue and, occasionally, iritis.
Cervical extension injury
Anterior or posterior neck pain may develop within hours or days following a whiplash injury. Anterior pain usually diminishes within several days, but posterior pain persists and may even intensify. Associated findings include tenderness, swelling and nuchal rigidity, arm or back pain, occipital headache, muscle spasms, visual blurring, and unilateral miosis on the affected side.
Cervical fibrositis
This disorder may produce anterior neck pain that radiates to one or both shoulders. Pain is intermittent and variable, often changing with weather patterns. Other findings are nonspecific but commonly include point tenderness over involved muscles.
Cervical spine fracture
Fracture at C1 to C4 can cause sudden death; survivors may experience severe neck pain that restricts all movement, intense occipital headache, quadriplegia, deformity, and respiratory paralysis.
Cervical spine infection (acute)
This infection can cause neck pain that restricts motion. Other findings include fever, possible deformity, muscle spasms, local tenderness, dysphagia, paresthesia, and muscle weakness.
Cervical spine tumor
Metastatic tumors typically produce persistent neck pain that increases with movement and isn’t relieved by rest; primary tumors cause mild to severe pain along a specific nerve root. Other findings depend on the lesions and may include paresthesia, arm and leg weakness that progresses to atrophy and paralysis, and bladder and bowel incontinence.
Cervical spondylosis
This degenerative process produces posterior neck pain that restricts movement and is aggravated by it. Pain may radiate down either arm and may accompany paresthesia, weakness, and stiffness.
Cervical stenosis
This progressive disorder, commonly asymptomatic, may cause nonspecific neck and arm pain, paresthesia, muscle weakness or paralysis, and decreased range of motion.
Esophageal trauma
An esophageal mucosal tear or a pulsion diverticulum may produce mild neck pain, chest pain, edema, hemoptysis, and dysphagia.
Herniated cervical disk
This disorder characteristically causes variable neck pain that restricts movement and is aggravated by it. It also causes referred pain along a specific dermatome, paresthesia and other sensory disturbances, and arm weakness.
Hodgkin’s lymphoma
This disorder may eventually result in generalized pain that may affect the neck. Lymphadenopathy, the classic sign, may accompany paresthesia, muscle weakness, fever, fatigue, weight loss, malaise, and hepatomegaly.
Laryngeal cancer
Neck pain that radiates to the ear develops late in this disorder. The patient may also develop dysphagia, dyspnea, hemoptysis, stridor, hoarseness, and cervical lymphadenopathy.
Lymphadenitis
With this disorder, enlarged and inflamed cervical lymph nodes cause acute pain and tenderness. Fever, chills, and malaise may also occur.
Meningitis
Neck pain may accompany characteristic nuchal rigidity. Related findings include fever, headache, photophobia, positive Brudzinski’s and Kernig’s signs, and decreased level of consciousness.
Neck sprain
Minor sprains typically produce pain, slight swelling, stiffness, and restricted range of motion. Ligament rupture causes pain, marked swelling, ecchymosis, muscle spasms, and nuchal rigidity with head tilt.
Osteoporosis
Neck pain is rare with this disorder, which usually affects the thoracic or lumbar vertebrae. Cervical vertebrae involvement produces tenderness and deformity.
Paget’s disease
This slowly developing disease is commonly asymptomatic in its early stages. As it progresses, cervical vertebrae deformity may produce severe, persistent neck pain, along with paresthesia and arm weakness or paralysis.
Rheumatoid arthritis
This disorder usually affects peripheral joints, but it can also involve the cervical vertebrae. Acute inflammation may cause moderate to severe pain that radiates along a specific nerve root; increased warmth, swelling, and tenderness in involved joints; stiffness, restricting range of motion; paresthesia and muscle weakness; low-grade fever; anorexia; malaise; fatigue; and possible neck deformity. Some pain and stiffness remain after the acute phase.
Spinous process fracture
Fracture near the cervicothoracic junction produces acute pain radiating to the shoulders. Associated findings include swelling, exquisite tenderness, restricted range of motion, muscle spasms, and deformity.
Subarachnoid hemorrhage
This life-threatening condition may cause moderate to severe neck pain and rigidity, headache, and a decreased level of consciousness. Kernig’s and Brudzinski’s signs are present. The patient may describe the headache as “the worst headache of my life.”
Thyroid trauma
Besides mild to moderate neck pain, thyroid trauma may cause local swelling and ecchymosis. If a hematoma forms, it can cause dyspnea.
Torticollis
With this neck deformity, severe neck pain accompanies recurrent unilateral stiffness and muscle spasms that produce a characteristic head tilt.
Tracheal trauma
Fracture of the tracheal cartilage, a life-threatening condition, produces moderate to severe neck pain and respiratory difficulty.
Torn tracheal mucosa produces mild to moderate pain and may result in airway occlusion, hemoptysis, hoarseness, and dysphagia.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Neck Pain:
Differential Overview
(Field Guide to Bedside Diagnosis)
Posterior
❑ Musculoligamentous strain
❑ Cervical spondylosis
❑ Cervical root compression
❑ Posterior cervical lymphadenopathy
❑ Meningeal inflammation
❑ Cervical fracture
❑ Atlantoaxial subluxation
Anterior
❑ Anterior cervical lymphadenopathy
❑ Thyroiditis
❑ Myocardial ischemia
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Ankylosing spondylitis:
Causes
(Handbook of Diseases)
Recent evidence strongly suggests a familial tendency in ankylosing spondylitis. The presence of histocompatibility antigen HLA-B27 (positive in over 90% of patients with this disease) and circulating immune complexes suggests immunologic activity. A possible link to underlying infection is being investigated.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Juvenile rheumatoid arthritis:
Causes
(Handbook of Diseases)
JRA is thought to be an autoimmune disorder. Research has linked causation to genetic and immune factors. Viral or bacterial (particularly streptococcal) infection, trauma, and emotional stress have been identified as precipitating factors.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Rheumatoid arthritis:
Causes
(Handbook of Diseases)
What causes the chronic inflammation characteristic of RA isn’t known. One theory states that abnormal immune activation (occurring in a genetically susceptible individual) leads to inflammation, complement activation, and cell proliferation within joints and tendon sheaths. Although no single environmental factor has been found to be a consistent and reproducible cause of this response, infection (viral or bacterial), hormonal factors, and lifestyle factors may all influence disease onset.
Some RA patients develop an immunoglobulin (Ig) M antibody against their body’s own IgG, which is called RF. Increased production of this antibody may also play a role in genetic inflammation.
Pathogenesis
Much more is known about the pathogenesis of RA than about its causes. If unarrested, the inflammatory process within the joints occurs in four stages.
In the first stage, synovitis develops from congestion and edema of the synovial membrane and joint capsule. Infiltration by lymphocytes, macro-phages, and neutrophils perpetuates the local inflammatory response. These cells, as well as fibroblast-like synovial cells, produce enzymes that help to degrade bone and cartilage.
Formation of pannus — thickened layers of granulation tissue — marks the onset of the second stage. Pannus covers and invades cartilage and eventually destroys the joint capsule and bone.
Progression to the third stage is characterized by fibrous ankylosis — fibrous invasion of the pannus and scar formation that occludes the joint space. Bone atrophy and malalignment cause visible deformities and disrupt the articulation of opposing bones, causing muscle atrophy and imbalance and, possibly, partial dislocations or subluxations.
In the fourth stage, fibrous tissue calcifies, resulting in bony ankylosis and total immobility.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Neck pain:
Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Ankylosing spondylitis
Intermittent, moderate to severe neck pain and stiffness with severely restricted ROM is characteristic of ankylosing spondylitis. Intermittent low back pain and stiffness and arm pain are generally worse in the morning or after periods of inactivity and are usually relieved after exercise. Related findings also include low-grade fever, limited chest expansion, malaise, anorexia, fatigue and, occasionally, iritis.
Cervical extension injury
Anterior or posterior neck pain may develop within hours or days after a whiplash injury. Anterior pain usually diminishes within several days, but posterior pain persists and may even intensify. Associated findings include tenderness, swelling and nuchal rigidity, arm or back pain, occipital headache, muscle spasms, blurred vision, and unilateral miosis on the affected side.
Cervical fibrositis
Cervical fibrositis may produce anterior neck pain that radiates to one or both shoulders. Pain is intermittent and variable, commonly changing with weather patterns. Other findings are nonspecific but usually include point tenderness over involved muscles.
Cervical spine fracture
A fracture at C1 to C4 can cause sudden death; survivors may experience severe neck pain that restricts all movement, intense occipital headache, quadriplegia, deformity, and respiratory paralysis.
Cervical spine infection (acute)
Cervical spine infection can cause neck pain that restricts motion. Other findings include fever, possible deformity, muscle spasms, local tenderness, dysphagia, paresthesia, and muscle weakness.
Cervical spine tumor
Metastatic tumors typically produce persistent neck pain that increases with movement and isn’t relieved by rest; primary tumors cause mild to severe pain along a specific nerve root. Other findings depend on the lesions and may include paresthesia, arm and leg weakness that progresses to atrophy and paralysis, and bladder and bowel incontinence.
Cervical spondylosis
Cervical spondylosis is a degenerative process that produces posterior neck pain that restricts movement and is aggravated by it. Pain may radiate down either arm and may accompany paresthesia, weakness, and stiffness.
Cervical stenosis
Cervical stenosis is a progressive disorder, commonly asymptomatic, that may cause nonspecific neck and arm pain, paresthesia, muscle weakness or paralysis, and decreased ROM.
Esophageal trauma
An esophageal mucosal tear or a pulsion diverticulum may produce mild neck pain, chest pain, edema, hemoptysis, and dysphagia.
Herniated cervical disk
Herniated cervical disk characteristically causes variable neck pain that restricts movement and is aggravated by it. It also causes referred pain along a specific dermatome, paresthesia and other sensory disturbances, and arm weakness.
Hodgkin’s lymphoma
Hodgkin’s lymphoma may eventually result in generalized pain that may affect the neck. Lymphadenopathy, the classic sign, may accompany paresthesia, muscle weakness, fever, fatigue, weight loss, malaise, and hepatomegaly.
Laryngeal cancer
Neck pain that radiates to the ear develops late in laryngeal cancer. The patient may also develop dysphagia, dyspnea, hemoptysis, stridor, hoarseness, and cervical lymphadenopathy.
Lymphadenitis
With lymphadenitis, enlarged and inflamed cervical lymph nodes cause acute pain and tenderness. Fever, chills, and malaise may also occur.
Meningitis
Neck pain may accompany characteristic nuchal rigidity of meningitis. Related findings include fever, headache, photophobia, positive Brudzinski’s and Kernig’s signs, and a decreased level of consciousness (LOC).
Neck sprain
Minor sprains typically produce pain, slight swelling, stiffness, and restricted ROM. Ligament rupture causes pain, marked swelling, ecchymosis, muscle spasms, and nuchal rigidity with head tilt.
Osteoporosis
Neck pain is rare with osteoporosis, which usually affects the thoracic or lumbar vertebrae. Cervical vertebrae involvement produces tenderness and deformity.
Paget’s disease
Paget’s disease is a slowly developing disease that’s commonly asymptomatic in its early stages. As it progresses, cervical vertebrae deformity may produce severe, persistent neck pain, along with paresthesia and arm weakness or paralysis.
Rheumatoid arthritis (RA)
Although RA typically affects peripheral joints, it can also involve the cervical vertebrae. Acute inflammation may cause moderate to severe pain that radiates along a specific nerve root accompanied by increased warmth, swelling, and tenderness in involved joints. Stiffness may restrict the patient’s ROM. He may also experience paresthesia and muscle weakness, low-grade fever, anorexia, malaise, fatigue and, possibly, neck deformity. Some pain and stiffness remain after the acute phase.
Spinous process fracture
Fracture near the cervicothoracic junction produces acute pain radiating to the shoulders. Associated findings include swelling, exquisite tenderness, restricted ROM, muscle spasms, and deformity.
Subarachnoid hemorrhage
In subarachnoid hemorrhage, Kernig’s and Brudzinski’s signs are present. The patient may also develop a headache, possibly describing it as “the worst headache of my life.”
ALERT: Subarachnoid hemorrhage is a life-threatening condition. In addition to Kernig’s and Brudzinski’s signs and a headache, it may also cause moderate to severe neck pain and rigidity and a decreased LOC.
Thyroid trauma
Besides mild to moderate neck pain, thyroid trauma may cause local swelling and ecchymosis. If a hematoma forms, it can cause dyspnea.
Torticollis
With torticollis, severe neck pain accompanies recurrent unilateral stiffness and muscle spasms that produce a characteristic head tilt.
Tracheal trauma
Fracture of the tracheal cartilage, a life-threatening condition, produces moderate to severe neck pain and respiratory difficulty. Torn tracheal mucosa produces mild to moderate pain and may result in airway occlusion, hemoptysis, hoarseness, and dysphagia.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Neck pain:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Cervical extension injury
Anterior or posterior neck pain may develop within hours or days following a whiplash injury. Anterior pain usually diminishes within several days, but posterior pain persists and may even intensify. Associated findings include tenderness, swelling and nuchal rigidity, arm or back pain, occipital headache, muscle spasms, visual blurring, and unilateral miosis on the affected side.
Cervical spine fracture
Fracture at C1 to C4 can cause sudden death; survivors may experience severe neck pain that restricts all movement, intense occipital headache, quadriplegia, deformity, and respiratory paralysis.
Cervical spine tumor
Metastatic tumors typically produce persistent neck pain that increases with movement and isn’t relieved by rest; primary tumors cause mild to severe pain along a specific nerve root. Other findings depend on the lesions and may include paresthesia, arm and leg weakness that progresses to atrophy and paralysis, and bladder and bowel incontinence.
Cervical spondylosis
Cervical spondylosis, a degenerative process, produces posterior neck pain that’s aggravated by and restricts movement. Pain may radiate down either arm and may accompany paresthesia, weakness, and stiffness.
Cervical stenosis
Cervical stenosis is a progressive disorder that commonly produces no symptoms. It may cause nonspecific neck and arm pain, paresthesia, muscle weakness or paralysis, and decreased ROM. The patient may report hand clumsiness and problems with gait and balance.
Herniated cervical disk
A herniated cervical disk characteristically causes variable neck pain that is aggravated by and restricts movement. It also causes referred pain along a specific dermatome, paresthesia and other sensory disturbances, and arm weakness.
Hodgkin’s lymphoma
Hodgkin’s lymphoma may eventually result in generalized pain that may affect the neck. Lymphadenopathy, the classic sign, may accompany paresthesia, muscle weakness, fever, fatigue, weight loss, malaise, and hepatomegaly.
Laryngeal cancer
Neck pain that radiates to the ear develops late in laryngeal cancer. The patient may also develop dysphagia, dyspnea, hemoptysis, stridor, hoarseness, and cervical lymphadenopathy.
Lymphadenitis
With lymphadenitis, enlarged and inflamed cervical lymph nodes cause acute pain and tenderness. Fever, chills, and malaise may also occur.
Meningitis
With meningitis, neck pain may accompany characteristic nuchal rigidity. Related findings include fever, headache, photophobia, positive Brudzinski’s and Kernig’s signs, and decreased level of consciousness (LOC).
Neck sprain
Minor sprains typically produce pain, slight swelling, stiffness, and restricted ROM. Ligament rupture causes pain, marked swelling, ecchymosis, muscle spasms, and nuchal rigidity with head tilt.
Paget’s disease
Paget’s disease commonly produces no symptoms in its early stages. As it progresses, cervical vertebrae deformity may produce severe, persistent neck pain along with paresthesia and arm weakness or paralysis.
Rheumatoid arthritis
Rheumatoid arthritis usually affects peripheral joints, but it can also involve the cervical vertebrae. Acute inflammation may cause moderate to severe pain that radiates along a specific nerve root; increased warmth, swelling, and tenderness in involved joints; stiffness, restricting ROM; paresthesia and muscle weakness; low-grade fever; anorexia; malaise; fatigue; and possible neck deformity. Some pain and stiffness remain after the acute phase.
Spinous process fracture
Fracture near the cervicothoracic junction produces acute pain radiating to the shoulders. Associated findings include swelling, exquisite tenderness, restricted ROM, muscle spasms, and deformity.
Subarachnoid hemorrhage
Subarachnoid hemorrhage is a life-threatening condition that may cause moderate to severe neck pain and rigidity, headache, and a decreased LOC. Kernig’s and Brudzinski’s signs are present. The patient may describe the headache as “the worst headache of my life.”
Torticollis
With torticollis, severe neck pain accompanies recurrent unilateral stiffness and muscle spasms. Stiffness of the neck muscles is followed by a momentary twitching or contraction that pulls the head to the affected side.
Tracheal trauma
Fracture of the tracheal cartilage, a life-threatening condition, produces moderate to severe neck pain and respiratory difficulty. Torn tracheal mucosa produces mild to moderate pain and may result in airway occlusion, hemoptysis, hoarseness, and dysphagia.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Neck pain:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Ankylosing spondylitis.Intermittent, moderate to severe neck pain and stiffness with severely restricted ROM is characteristic of ankylosing spondylitis. Intermittent low back pain and stiffness and arm pain are generally worse in the morning or after periods of inactivity and are usually relieved after exercise. Related findings also include a low-grade fever, limited chest expansion, malaise, anorexia, fatigue and, occasionally, iritis.
Cervical extension injury.Anterior or posterior neck pain may develop within hours or days following a whiplash injury. Anterior pain usually diminishes within several days, but posterior pain persists and may even intensify. Associated findings include tenderness, swelling and nuchal rigidity, arm or back pain, an occipital headache, muscle spasms, visual blurring, and unilateral miosis on the affected side.
Cervical spine fracture.Fracture at C1 to C4 can cause sudden death; survivors may experience severe neck pain that restricts all movement, an intense occipital headache, quadriplegia, deformity, and respiratory paralysis.
Cervical spine tumor.Metastatic cervical spine tumors typically produce persistent neck pain that increases with movement and isn't relieved by rest; primary tumors cause mild to severe pain along a specific nerve root. Other findings depend on the lesions and may include paresthesia, arm and leg weakness that progresses to atrophy and paralysis, and bladder and bowel incontinence.
Cervical spondylosis.Cervical spondylosis produces posterior neck pain that restricts movement and is aggravated by it. Pain may radiate down either arm and may accompany paresthesia, weakness, and stiffness.
Esophageal trauma.An esophageal mucosal tear or a pulsion diverticulum may produce mild neck pain, chest pain, edema, hemoptysis, and dysphagia.
Herniated cervical disk.A herniated cervical disk characteristically causes variable neck pain that restricts movement and is aggravated by it. It also causes referred pain along a specific dermatome, paresthesia and other sensory disturbances, and arm weakness.
Laryngeal cancer.Neck pain that radiates to the ear develops late in laryngeal cancer. The patient may also develop dysphagia, dyspnea, hemoptysis, stridor, hoarseness, and cervical lymphadenopathy.
Lymphadenitis.With lymphadenitis, enlarged and inflamed cervical lymph nodes cause acute pain and tenderness. Fever, chills, and malaise may also occur.
Meningitis.With meningitis, neck pain may accompany characteristic nuchal rigidity. Related findings include fever, headache, photophobia, positive Brudzinski's and Kernig's signs, and decreased level of consciousness (LOC).
Neck sprain.Minor neck sprains typically produce pain, slight swelling, stiffness, and restricted ROM. Ligament rupture causes pain, marked swelling, ecchymosis, muscle spasms, and nuchal rigidity with head tilt.
Rheumatoid arthritis.Rheumatoid arthritis usually affects peripheral joints, but it can also involve the cervical vertebrae. Acute inflammation may cause moderate to severe pain that radiates along a specific nerve root; increased warmth, swelling, and tenderness in involved joints; stiffness, restricting ROM; paresthesia and muscle weakness; low-grade fever; anorexia; malaise; fatigue; and possible neck deformity. Some pain and stiffness remain after the acute phase.
Spinous process fracture.A fracture near the cervicothoracic junction produces acute pain radiating to the shoulders. Associated findings include swelling, exquisite tenderness, restricted ROM, muscle spasms, and deformity.
Subarachnoid hemorrhage.Subarachnoid hemorrhage isalife-threatening condition that may cause moderate to severe neck pain and rigidity, headache, and decreased LOC. Kernig's and Brudzinski's signs are present.
Thyroid trauma.Besides mild to moderate neck pain, thyroid trauma may cause local swelling and ecchymosis. If a hematoma forms, it can cause dyspnea.
Torticollis.Torticollis is a neck deformity in which severe neck pain accompanies recurrent unilateral stiffness and muscle spasms that produce a characteristic head tilt.
Tracheal trauma.A fracture of the tracheal cartilage, a life-threatening condition, produces moderate to severe neck pain and respiratory difficulty.
Torn tracheal mucosa produces mild to moderate pain and may result in airway occlusion, hemoptysis, hoarseness, and dysphagia.
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Source: Nursing: Interpreting Signs and Symptoms, 2007
For most people, arthritis means simply pain in or around a joint. But there are over 100 different kinds of arthritis, each with its own set of...
For most people, arthritis means simply pain in or around a joint. But there are over 100 different kinds of arthritis, each with its own set of...
For most people, arthritis means simply pain in or around a joint. But there are over 100 different kinds of arthritis, each with its own set of...
A childhood psychiatrist helps explore the affect of Crohns and ulcerative colitis, types of inflammatory bowel disease children and their families.
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