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Volume 89, Issue 3, Supplement 1, Pages S41-S46 (March 2008)


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Interventions in Chronic Pain Management. 2. Diagnosis of Cervical and Thoracic Pain Syndromes

Mitchell K. Freedman, DOaCorresponding Author Informationemail address, E. Anthony Overton, DOa, Michael F. Saulino, MDb, Michele Y. Holding, MDc, Ira D. Kornbluth, MDd

Abstract 

Freedman MK, Overton EA, Saulino MF, Holding MY, Kornbluth ID. Interventions in chronic pain management. 2. Diagnosis of cervical and thoracic pain syndromes.

This self-directed learning module highlights approaches to the investigation of common cervical and thoracic conditions. It is part of the chapter on chronic pain management in the Self-Directed Physiatric Education Program for practitioners in physical medicine and rehabilitation. The differential diagnosis of cervical and thoracic syndromes as well as cervicogenic headache is reviewed. The need for a comprehensive history and physical examination is emphasized. Indications for diagnostic tests including magnetic resonance imaging, computed tomography scan, bone scan, diskography, radiographs, diagnostic injections, and electrodiagnostic studies are discussed with the idea that testing should be performed and interpreted with the specific clinical presentation in mind.

Overall Article Objective

To discuss the differential diagnoses for and investigation of common cervical and thoracic conditions and cervicogenic headache.

a Rothman Institute, Philadelphia, PA

b Moss Rehabilitation, Elkins Park, PA

c The Back Pain Center, Phoenixville, PA

d Spine Medicine and Rehabilitation Therapies, Westminster, MD.

Corresponding Author InformationCorrespondence to Mitchell K. Freedman, DO, Rothman Institute, 925 Chestnut St, Philadelphia, PA 19107

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

 Reprints are not available from the author.

PII: S0003-9993(07)01851-5

doi:10.1016/j.apmr.2007.12.004


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