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Fulltext What the mind does not know, the eyes do not see: a rare congenital fusion of the odontoid process to the atlantal hemiarch

Sureisen M, Achannan R, Chong KC, Wong CC

BMJ Case Rep, 2015 Oct 27;2015.
PMID: 26508120 DOI: 10.1136/bcr-2015-212748

Congenital spinal fusion of an odontoid process to an atlantal hemiarch is very rare. The unfamiliarity of the medical fraternity with this congenital malformation can easily be mistaken for an acute fracture, chronic infection or inflammatory disease. We present our experience of managing an adult who presented with neck pain after a motor vehicle accident. Radiological investigation revealed congenital fusion of the odontoid process to the atlantal hemiarch. The prevalence, embryology and clinical significance of this anomaly are discussed. As the natural progression of this anomaly is not well documented, we suggest periodic follow-up to monitor the progression of degenerative changes and instability of the occipitoatlantal junction.

Matched MeSH terms: Neck Pain/etiology
Fulltext Understanding upper body playing-related musculoskeletal disorders among piano and non-piano players using a photogrammetry

Yuen GK, Clements JB, Ramalingam V, Sundar V

Clin Ter, 2021 Mar 15;172(2):163-167.
PMID: 33763681 DOI: 10.7417/CT.2021.2305

Conclusion: The obtained results conclude piano players are highly prone to the risk of developing PRMSD in the upper body.
Results: The findings showed piano players have a higher NDI, lower CVA, and RSP when compared with the non-piano players at a statistically significant level of p-value <0.05.
Objective: Playing-related musculoskeletal disorders (PRMSD) are a common problem for the pianist. The poor upper body ergonomics influences the natural positioning of the neck and shoulders, which involves forward head posture (FHP) and rounded shoulder posture (RSP). This misaligned position could produce a sensation of pain over the upper body, which affects the piano player and computer users with similar ergonomic posture. Recently, photogrammetry methods are commonly applied in a clinical setting to assess posture. The goal of this research is to compare the upper body playing-related muscu-loskeletal disorders between the piano and the non-piano players by applying photogrammetry.
Materials and Methods: This causal-comparative study includes 70 participants with 35 piano and 35 non-piano players. The participant's FHP was assessed using a digitized photo to record the Craniovertebral angle (CVA) with the support of Kinovea software. Besides, digital Vernier Calliper used to assess the scapular index on the RSP and Neck disability indices (NDI) used to measure neck pain and functional disability of the participants.

Matched MeSH terms: Neck Pain/epidemiology
Fulltext Ultrasound Guided Nerve Root Injection in Patients with Cervical Spondylytic Radicular Pain

Choong, L.T.

Malays Orthop J, 2009;3(1):68-71.
MyJurnal

Selective cervical nerve root injection using a mixture of corticosteroid and lignocaine is a treatment option for managing cervical radiculopathic pain. The procedure is usually performed under image guided fluoroscopy or Computerized Tomograhy. Ultrasound-guided cervical nerve root block does not expose the patients and personnel to radiation. During injection, the fluid is mostly visualized in a real-time fashion. This retrospective study reviewed the effectiveness of ultrasound in guiding cervical peri-radicular injection for pain relief in patients with recalcitrant cervical radiculopathy. There were no complications reported in this series.

Matched MeSH terms: Neck Pain
Typhoid spondylodiscitis of the cervical spine

Norisyam Y, Jayamalar T, Foo CH, Ohn KM

BMJ Case Rep, 2023 Dec 21;16(12).
PMID: 38129083 DOI: 10.1136/bcr-2023-255033

Spinal infection comprises pyogenic and non-pyogenic spondylodiscitis. This condition may manifest with non-specific clinical symptoms, elevated infective parameters and imaging findings that are difficult to distinguish. The cornerstone of a definitive diagnosis and subsequent successful treatment lies in tissue analysis through culture and histopathological studies. In this context, we present a case of Salmonella pyogenic spondylodiscitis affecting the C5/C6 vertebrae, complicated by Salmonella bacteraemia and characterised by mechanical neck pain that curtails daily activities and overall functioning, although without neurological deficits. The uniqueness of this case stems from its occurrence in an immunocompetent individual from a non-endemic area, with no identifiable sources of Salmonella infection or preceding gastrointestinal symptoms.

Matched MeSH terms: Neck Pain
Fulltext The impact of dry needling on patients with neck pain in a tertiary hospital

Ho, S.E., Loong, S., Fatin Nur Laily R., Wan Nur Aizzati M., Muhammad Firdaus I.Z., Ho, Christopher C.K., et al.

Journal of Surgical Academia, 2015;5(1):44-50.
MyJurnal

Neck pain presents as a symptom of dull pain or discomfort mainly along the trapezius muscle. Dry needling is an invasive procedure which uses acupuncture needle directed at myofascial trigger points. The aim of the study was to evaluate the effectiveness of dry needling in managing patients with neck pain. A pre-test-post-test interventional study design was used. Patient education package was provided to 32 respondents who fulfilled the inclusion criteria. A 13-item Pain Catastrophizing Scale (PCS) questionnaire was used to assess Rumination, Magnification and Helplessness. Subjective pain intensity was measured by Visual Analogue Scale (VAS). These questionnaires were given before and after the dry needling intervention. The findings reported that respondents scored high in pre-test total PCS score (27.41±13.652). Post-test result revealed a significant improvement in total PCS score (23.06±13.938) (p = 0.000). Post-test VAS score (4.78±1.237) was also significantly better than pre-test (6.47±1.414) (p = 0.000). There was no significant difference in pre-test PCS in terms of marital status (p > 0.05) whereas there was significant difference between marital status and rumination in post-test (Z = -2.303, p = 0.021). There was significant difference between pre-test magnification in terms of respondents’ occupation (p = 0.008) and race (p = 0.035) but no significant difference in post-test. Respondents’ age group showed no significant differences between pre-test and post-test PCS and VAS (p > 0.05). In conclusion, patients who received dry needling showed improvement in pain intensity and catastrophizing towards neck pain.

Matched MeSH terms: Neck Pain
Fulltext Socio-demographic and physical factors associated with disability in adults with non- specific chronic neck pain

Ponvel, P., Devinder K.A. Singh, Yan Hang, M., Muniandy Y., Mokhtar, S.

Medicine & Health, 2018;13(2):122-132.
MyJurnal

While socio-demographic, physical and other factors are associated with neck pain, there is scanty literature about how these factors are associated with disability in adults suffering from this condition. We aimed to determine the socio-demographic and physical (strength and range of motions) related factors of disability in adults with non-specific chronic neck pain. A total of 34 adults with neck pain, with mean age 55 (10.80) years from a physiotherapy clinic in a teaching hospital participated in this study. Socio-demographic details such as body mass index (BMI), current employment status, hours of exercise done a week were obtained. Severity of pain was evaluated using the Numerical Rating Scale (NRS). Disability level was assessed using Neck Disability Index. Cervical range of motion was measured using the Cervical Range of Motion device. A hand dynamometer was used to measure the dominant hand grip muscle strength. The data was analyzed using descriptive and stepwise linear regression analysis. More than half the participants were females, above 50 years, in the overweight group (BMI>25 kg/m2), currently unemployed and had severe neck pain (NRS >7). Handgrip strength was the only factor found to be significantly (p

Matched MeSH terms: Neck Pain
Fulltext Scalene myofascial pain syndrome mimicking cervical disc prolapse: a report of two cases

Abd Jalil N, Awang MS, Omar M

Malays J Med Sci, 2010 Jan;17(1):60-6.
PMID: 22135529 MyJurnal

Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain syndrome mimics cervical radiculopathy, this condition often leads to mismanagement, which can, in turn, result in persistent pain and suffering. In the worst-case scenarios, patients may be subjected to unjustifiable surgical intervention. Because the clinical findings in scalene myofascial pain syndrome are "pathognomonic", clinicians should be aware of ways to recognize this disorder and be able to differentiate it from other conditions that present with neck pain and rediculopathy. We present two cases of unilateral scalene myofascial pain syndrome that significantly impaired the patients' functioning and quality of life. This case report serves to create awareness about the existence of the syndrome and to highlight the potential morbidity due to clinical misdiagnosis.

Matched MeSH terms: Neck Pain
Rheumatic diseases in the APLAR region

Davatchi F

APLAR Journal of Rheumatology, 2006;9(1):5-10.
DOI: 10.1111/j.1479-8077.2006.00177.x
Matched MeSH terms: Neck Pain
Fulltext Remission of recalcitrant dermatomyositis following a chiropractic adjustment

Chu ECP, Lo FS, Bhaumik A

J Family Med Prim Care, 2019 Nov;8(11):3742-3744.
PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19

Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.

Matched MeSH terms: Neck Pain
Relationships between Cornell Musculoskeletal Discomfort Questionnaire and Online Rapid Office Strain Assessment Questionnaire

Shariat A, Cleland JA, Danaee M, Kargarfard M, Moradi V, Bahri Mohd Tamrin S

Iran J Public Health, 2018 Nov;47(11):1756-1762.
PMID: 30581794

Background: The Rapid Office Strain Assessment (ROSA) is a tool employed online to screen office workstations, which may require modification to decrease musculoskeletal discomfort of workers. This study aimed to examine if the ROSA is able to evaluate pain severity in the lower back, shoulder and neck of office workers accurately.
Methods: Overall, 142 participants (height: 1.80 ± 0.15 m, BMI: 26.08± 6.70, age: 35±15 yr) with at least a year of working experience completed both questionnaires, the online ROSA and the Cornell musculoskeletal discomfort, in 2016 in Malaysia.
Results: Relationship between the total scores of both questionnaires for lower back, shoulder and neck pain were significant but exhibited a weak to moderate relationship (range of r values from 0.012 (CI 95%, -0.153-0.176) to 0.503 (CI 95%, 0.369-0.616).
Conclusion: The online ROSA does not appear to be a reasonable tool for evaluating the severity of lower back, shoulder and neck pain among office workers as the correlations were low. We suggest continued use of the musculoskeletal discomfort questionnaire. Additional studies are required to further examine the ROSA for other anatomical regions.

Matched MeSH terms: Neck Pain
Prolonged writing task: comparison of electromyographic analysis of upper trapezius muscle in subjects with or without neck pain

Leonard JH, Kok KS, Ayiesha R, Das S, Roslizawati N, Vikram M, et al.

Clin Ter, 2010;161(1):29-33.
PMID: 20393675

Work related musculoskeletal disorders represent a serious public health problem as it is a leading cause for disability and absenteeism in workers. The main purpose of the present quasi-experimental study was to compare the muscle activity of the upper trapezius in subjects with neck pain and compare it to those of normal subjects.

Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Neck Pain/etiology*; Neck Pain/physiopathology
Fulltext Prevalence of neck pain and associated factors with personal characteristics, physical workloads and psychosocial among male rubber workers in FELDA settlement Malaysia

Shan CL, Bin Adon MY, Rahman AB, Hassan ST, Ismail KB

Glob J Health Sci, 2012 Jan;4(1):94-104.
PMID: 22980103 DOI: 10.5539/gjhs.v4n1p94

Rubber tapping processes posed potential risk of various health problems among rubber workers. It ranges from simple musculoskeletal aches to more serious and complicated structural damage to bone, muscles, tendons and nerves of musculoskeletal system. These health problems might be linked directly to the arduous demands of farm labor.

Matched MeSH terms: Neck Pain/epidemiology*; Neck Pain/physiopathology
Position of document holder and work related risk factors for neck pain among computer users: a narrative review

Ambusam S, Baharudin O, Roslizawati N, Leonard J

Clin Ter, 2015 Nov-Dec;166(6):256-61.
PMID: 26794814 DOI: 10.7417/CT.2015.1898

Document holder is used as a remedy to address occupational neck pain among computer users. An understanding on the effects of the document holder along with other work related risk factors while working in computer workstation requires attention. A comprehensive knowledge on the optimal location of the document holder in computer use and associated work related factors that may contribute to neck pain reviewed in this article. A literature search has been conducted over the past 14 years based on the published articles from January 1990 to January 2014 in both Science Direct and PubMed databases. Medical Subject Headings (MeSH) keywords for search were neck muscle OR head posture OR muscle tension' OR muscle activity OR work related disorders OR neck pain AND/OR document location OR document holder OR source document OR copy screen holder.Document holder placed lateral to the screen was most preferred to reduce neck discomfort among occupational typists. Document without a holder was placed flat on the surface is least preferred. The head posture and muscle activity increases when the document is placed flat on the surface compared to when placed on the document holder. Work related factors such as static posture, repetitive movement, prolong sitting and awkward positions were the risk factors for chronic neck pain. This review highlights the optimal location for document holder for computer users to reduce neck pain. Together, the importance of work related risk factors for to neck pain on occupational typist is emphasized for the clinical management.

Matched MeSH terms: Neck Pain
Fulltext Plausible impact of forward head posture on upper cervical spine stability

Chu ECP, Lo FS, Bhaumik A

J Family Med Prim Care, 2020 May;9(5):2517-2520.
PMID: 32754534 DOI: 10.4103/jfmpc.jfmpc_95_20

The cervical spine is responsible for allowing mobility and stability to the head and neck. Any deviation to the center of gravity of the head results in an increase in cantilever loads, which can be particularly damaging to the upper cervical joints. Excessive neck bending also exaggerates stretching through the cervical spine and all of the spinal structures below. It has been reported that forward head posture (FHP) can cause a multitude of disorders including cervical radiculopathy, cervicogenic headaches and cervicogenic dizziness. Most of these conditions manifest with clusters of painful symptoms and spine dysfunctions. The purpose of this case study is to describe the radiographic imaging considerations and to illustrate the potential impacts in symptomatic adults with FHP. We randomly selected radiographs of three individuals with FHP who had undergone cervical adjustment for cervical pain. The occipito-axial (C0-C2) and atlanto-axial (C1-C2) joints were assessed via the C0-2 distance from the C2 base to the McGregor line (Redlund-Johnell criterion) and the Ranawat C1-2 index, in addition to subjective radiographic parameters. By comparing the radiographs of before-and-after intervention of each patient, a regressive joint spacing was observed from both indices. Such a long-lasting stretching concordant with FHP was assumed to be hazardous to joint stability. A definite conclusion, however, cannot be drawn due to the small sample size and a lack of convincing measurements.

Matched MeSH terms: Neck Pain
Fulltext Palliative care for a child: role of a primary care doctor

Tan CE, Md Radzniwan R, Khairani O, Ednin H

Malays Fam Physician, 2011;6(1):26-28.
PMID: 25606216 MyJurnal

A 7-year-old boy with a diagnosis of advanced medulloblastoma refractory to treatment was discharged from hospital for further palliative care at home. During this short and eventful period, the child developed spinal cord compression with progressive weakness of upper and lower limbs, neck pain, faecal and urinary incontinence. This case highlights the important roles of a primary care doctor in the provision of palliative care for a child in the community.

Matched MeSH terms: Neck Pain
Neck pain and paraplegia

Saniasiaya J

Emerg Med J, 2021 Mar;38(3):197-216.
PMID: 33619156 DOI: 10.1136/emermed-2020-209554
Matched MeSH terms: Neck Pain
Intracranial angiomatoid fibrous histiocytoma with Hodgkin lymphoma

Gunness VRN, Munoz I, González-López P, Alshafai N, Mikalkova A, Spears J

Med J Malaysia, 2019 Jun;74(3):234-236.
PMID: 31256181

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumour of uncertain differentiation and low metastatic potential, which occurs predominantly in children and young adults. It occurs mostly within the extremities, trunk, head and neck. We report the case of a 32-year-old female that was operated in our hospital in 2016 and twice in 2017. The patient had headaches and neck pain initially in 2016. We discuss the radiographic and histologic features initially found and the findings that ultimately led to the diagnosis of AFH. The patient had a past history of Hodgkin lymphoma.

Matched MeSH terms: Neck Pain
Fulltext Impact of Temporomandibular Joint Complaints on Tinnitus-Related Distress

Edvall NK, Gunan E, Genitsaridi E, Lazar A, Mehraei G, Billing M, et al.

Front Neurosci, 2019;13:879.
PMID: 31548840 DOI: 10.3389/fnins.2019.00879

There is increasing evidence of associations between the presence of temporomandibular joint (TMJ) disorders and tinnitus. It has been recently proposed that tinnitus patients with TMJ complaints could constitute a subtype, meaning a subgroup of tinnitus patients responsive to specific treatments. Tinnitus patients with TMJ complaints are often young women with somatosensory features of their tinnitus. Here, we investigate the socio-economic factors, phenotypic characteristics and psychological variables of tinnitus subjects from the Swedish Tinnitus Outreach Project, with (n = 486) or without (n = 1,996) TMJ complaints. The prevalence of TMJ complaints was greater in tinnitus subjects with severe tinnitus (36%) when compared to those with any tinnitus (19%), strongly indicating the contribution of TMJ problems to the severity of tinnitus. Comparing subgroups with or without TMJ complaints in the whole sample, differences were found regarding a large number of socioeconomic, phenotypic, and psychological characteristics. Subjects with TMJ complaints were more often women, more often reported stress as the cause of tinnitus, were more severely affected by tinnitus, scored worse in measures of psychological well-being and life quality, and were more often affected by problems tolerating sounds, headache, vertigo/dizziness, and neck pain. In addition, they more often reported pulsating and tonal tinnitus, somatic modulation of tinnitus, and aggravation of tinnitus by loud sounds and stress. When focusing the analysis in subjects with tinnitus as a big problem using the Tinnitus Functional Index cut-off ≥ 48, or with severe tinnitus according to the Tinnitus Handicap Inventory cut-off ≥ 58, the impact of somatosensory modulations and stress on tinnitus were greater in subjects with TMJ complaints in comparison to those without. In light of these results, we hypothesize that stress could contribute to the co-occurrence of TMJ problems and tinnitus and also to the development of severe tinnitus. Our study supports the need of involving dental care and stress management in the holistic treatment of patients with severe tinnitus.

Matched MeSH terms: Neck Pain
Grisel's syndrome: a rare complication of tonsillectomy

Sia KJ, Tang IP, Kong CK, Nasriah A

J Laryngol Otol, 2012 May;126(5):529-31.
PMID: 22361094 DOI: 10.1017/S0022215112000175

To discuss the pathophysiology of atlanto-axial subluxation as a rare complication of tonsillectomy, and to discuss the important radiological findings for diagnosis and treatment planning.

Matched MeSH terms: Neck Pain/etiology; Neck Pain/radiography; Neck Pain/therapy
Fulltext Endoscopic Transoral Resection of an Axial Chordoma: A Case Report

Taran S, Yusof AH, Yusof MI

Malays Orthop J, 2015 Nov;9(3):75-77.
PMID: 28611918 MyJurnal DOI: 10.5704/MOJ.1511.015

Upper cervical chordoma (UCC) is rare condition and poses unique challenges to surgeons. Even though transoral approach is commonly employed, a minimally invasive technique has not been established. We report a 44-year old Malay lady who presented with a 1 month history of insidious onset of progressive neck pain without neurological symptoms. She was diagnosed to have an axial (C2) chordoma. Intralesional resection of the tumour was performed transorally using the Destandau endoscopic system (Storz, Germany). Satisfactory intralesional excision of the tumour was achieved. She had a posterior fixation of C1-C4 prior to that. Her symptoms improved postoperatively and there were no complications noted. She underwent adjuvant radiotherapy to minimize local recurrence. Endoscopic excision of UCC via the transoral approach is a safe option as it provides an excellent magnified view and ease of resection while minimizing the operative morbidity.

Matched MeSH terms: Neck Pain

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