Spinal Manifestations of Systemic Disease

Dodson, Sean; Koontz, Nicholas A.

doi:10.1016/j.rcl.2018.10.005

Cited by 5 publications

(6 citation statements)

References 51 publications

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“…Our patient did not demonstrate any typical spinal imaging manifestations of GBS, which may include thickening of the cauda equina nerve roots with enhancement, often with a ventral nerve root predilection. 16,17 To date, a recent editorial correspondence reports a small observational series of 5 cases of suspected COVID-19-associated GBS, 8 but no prior detailed clinical reports have been published. In a previously reported case of possible COVID-19-associated GBS in a patient with recent travel to Wuhan, the patient manifested an atypical temporal profile with acute bilateral lower extremity weakness as an initial presenting symptom and subsequent development of COVID-19 pneumonia on hospital day 8, raising concern for coincidental disease processes and possible nosocomial infection.…”

Section: Discussionmentioning

confidence: 99%

COVID-19–Associated Bifacial Weakness with Paresthesia Subtype of Guillain-Barré Syndrome

Hutchins¹,

Jansen²,

Comer³

et al. 2020

AJNR Am J Neuroradiol

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We report a case of bifacial weakness with paresthesia, a recognized Guillain-Barré syndrome subtype characterized by rapidly progressive facial weakness and paresthesia without ataxia or other cranial neuropathies, which was temporally associated with antecedent coronavirus 2019 (COVID-19). This case highlights a potentially novel but critically important neurologic association of the COVID-19 disease process. Herein, we detail the clinicoradiologic work-up and diagnosis, clinical course, and multidisciplinary medical management of this patient with COVID-19. This case is illustrative of the increasingly recognized but potentially underreported neurologic manifestations of COVID-19, which must be considered and further investigated in this pandemic disease. ABBREVIATIONS: BFP ¼ bifacial weakness with paresthesia; CN ¼ cranial nerve; COVID-19 ¼ coronavirus 2019; GBS ¼ Guillain-Barré syndrome; HSV ¼ herpes simplex virus; Ig ¼ immunoglobulin; PCR ¼ polymerase chain reaction; SARS-CoV-2 ¼ Severe Acute Respiratory Syndrome coronavirus 2 S evere Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) is the novel coronavirus responsible for the pandemic coronavirus disease 2019 (COVID-19). First identified in Wuhan, China, in late December 2019, 1 global transmission increased rapidly, with the first case of COVID-19 reported in the United States on January 19, 2020 2 and .1.34 million cases and nearly 81,000 deaths reported in the United States as of May 12, 2020. 3 While the typical presentation is respiratory symptoms (dry cough and dyspnea), a number of other associated symptoms have been described, including fever, diarrhea, abdominal pain, fatigue, and altered mental status. Potential neurologic manifestations are increasingly recognized but may be underreported. 4-8 A potential association between COVID-19 and Guillain-Barré syndrome (GBS) has been suggested in 2 recent editorial correspondences; 7,8 however, the temporal relationship of GBS antecedent to COVID-19 symptomatology raised a question of causality in 1 report. 7 In this brief report, we detail a case of bifacial weakness with paresthesia subtype

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Section: Discussionmentioning

confidence: 99%

COVID-19–Associated Bifacial Weakness with Paresthesia Subtype of Guillain-Barré Syndrome

Hutchins¹,

Jansen²,

Comer³

et al. 2020

AJNR Am J Neuroradiol

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“…30 Syphilis causes Charcot arthropathy of the spine and (rarely) a gumma in the spinal canal that can compress the cord or the nerve roots. 31 Tuberculosis of the spine causes a slowly progressing illness, back pains, and deformity with various neurological abnormalities. 29 Spinal hydatid disease (Echinococcus granulosus) is rare: its manifestations are radiculopathy, myelopathy, and/or local pain due to bony destructive lesions, pathological fracture, and consequent cord compression.…”

Section: Infectionmentioning

confidence: 99%

“…6 Reactive arthritis tends to less involve the spine but it can cause inflammation of the vertebrae and intervertebral joints. 31 Bechet's disease rarely involves the spine and can cause myelitis and vasculitis of the cord. 14 Other rheumatic diseases, such as systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) can affect the spine.…”

Section: Infectionmentioning

confidence: 99%

NARRATIVE REVIEW A quick and comprehensive guide to differential diagnosis of neck and back pain: a narrative review

Krasin,

Schermann,

Snir

et al. 2024

Preprint

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The list of possible differential diagnoses for complaints of back and neck pain is enormously long. Many proposed diagnostic workups trying to avoid the challenge of considering all possible etiologies by early commitment to a specific area of the spine (i.e., neck or lower back). Others limit the differential diagnoses by pursuing a rational but limited goal, like ruling out conditions that may result in disability or death in the setting of an emergency department. We have briefly described a long list of medical conditions, each of which may present as back or neck pain, and whose prevalence ranges from common to very rare. We then showed that they all can be assigned to one of 7 groups according to judicious history taking, physical examination and simple imaging and laboratory tests: (1) pain that radiates from the cranium, chest or abdomen; (2) pain with signs of infection; (3) pain with signs of nerve root compression; (4) pain with signs of cord or cauda compression; (5) mechanical pain; (6) rheumatic pain; (7) pain with other characteristics, with or without local tenderness. Further referral to diagnostic tests and specialist consultations after initial assignment to one of these seven categories would save the patient time and unnecessary tests. We believe that this review and the proposed diagnostic algorithm may be valuable for medical education and for application in the primary care setting for the purpose of conducting a diagnostic workup of any type of back or neck pain in all patient groups and may be possibly used for development of diagnostic software and machine learning.

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“…Gonorrhea can cause meningitis of the cord, especially in immunosuppressed individuals. Syphilis causes Charcot arthropathy of the spine and (rarely) a gumma in the spinal canal that can compress the cord or the nerve roots [10]. Tuberculosis of the spine causes a slowly progressing illness, back pains, and deformity with various neurological abnormalities.…”

Section: Infectionmentioning

confidence: 99%

“…SLE can cause myelitis and vasculitis of the cord as well as atlantoaxial subluxation/dislocation [28]. Gout can affect the spine at any level, destroying the facet joints and causing hypointense lesions of the gout tophi that are visible in the extradural space on T1-weighted MRI [10]. Clinically, lumbar pain with radiculopathy will most often be observed as in a laterally herniated disc or spinal claudication as seen in spinal stenosis.…”

Section: Degenerative Rheumatic and Autoimmunementioning

confidence: 99%

A Quick and Comprehensive Guide to Differential Diagnosis of Neck and Back Pain: a Narrative Review

Krasin

Schermann

Snir

et al. 2022

SN Compr. Clin. Med.

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The list of diagnostic options when approaching a patient with axial pain is impressively complex. Many offer limited diagnostic workups, but we could not find a truly comprehensive diagnostic guide to assist in the diagnostic evaluation. In this short paper, we briefly described a long list of medical conditions, each of which can manifest as back or neck pain, and whose prevalence ranges from common to very rare. We then proposed an algorithm for classifying them into subgroups. Further referral to diagnostic tests and specialist consultations, after assignment to one of those subgroups, could save time and unnecessary tests. We believe that this review and the proposed diagnostic algorithm can be valuable for medical education and for use in the primary care setting for the diagnostic evaluation of any type of back or neck pain in all patient groups.

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Spinal Manifestations of Systemic Disease

Cited by 5 publications

References 51 publications

COVID-19–Associated Bifacial Weakness with Paresthesia Subtype of Guillain-Barré Syndrome

COVID-19–Associated Bifacial Weakness with Paresthesia Subtype of Guillain-Barré Syndrome

NARRATIVE REVIEW A quick and comprehensive guide to differential diagnosis of neck and back pain: a narrative review

A Quick and Comprehensive Guide to Differential Diagnosis of Neck and Back Pain: a Narrative Review

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