36 yr male with feature suggestive of imbalance while walking.
Daily drives 3 hrs
People get x ray cspine done for vertigo... But it's useless
Spondylosis is the rarest of rare causes of vertebrobasilar insufficiency
I guess that guy might be having labyrinthitis... Give him vertin and send him home 😐
It's clear cut case of loss of cervical lordosis. Radiologist have reported it as normal. This suggests early cervical spondylosis. I have an argument with him. That's why I wish to have your view on this. But you don't digest anything below MRI. 😄
Lol.. Loss of cervical lordosis is physiological mostly... What we tout as clinically relevant finding is mostly bullshit... Telling u by experience. The rad is right... Don't argue...
And spondylosis WONT cause imbalance
The patient is only 36 and if the disc spaces are not reduced... Then don't call spondylosis just bec of the straightening...
In the US we call it musculoligamentous sprain/ spasm.. It's also a rare entity but we have to use it all the time in all patients mostly... It sucks big time!
In case of muscle spasm
... u get this pic.its only suggestive of music spasm.....a natural protective phenomenon.
if no relief....mri
Yes.. But in MANY MANY normal patients too you get this finding .. It's hugely non specific
Pt presented with vertigo/ imbalance. Only in appropriate clinical setting it shud be called spasm... It's not a feature of spondylosis
Ok. That was one issue about finding of loss of cervical curvature which you say is not a feature of spondylosis.
Second association of spondylosis with imbalance.
Or spasm with imbalance
In cervical spondylosis also some pt complains of giddiness.... Subjective....xray protective muscle spasm...relieve with muscle relaxant. No role of cervical collar I think..needs. Neurologist's expert view.
Hi. Xray definitely cervical spasm. Diagnosis- IT Professional😂
Collars are contraindicated
Rx. Symptomatic only
And FYI... If u see any child's x ray/ MRI.. The curvature will be straightened or reversed. Just letting u know....
I wish to thank Dr. Shivram Gopal Iyer, Dr. Amit Gupta, Dr. Gautam Tripathi, Dr. Rupesh Jain for participating in discussion.
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