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

by Mitchell K. Freedman, DO, E. Anthony Overton, DO, Michael F. Saulino, MD, Michele Y. Holding, MD, Ira D. Kornbluth, MD

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.

Archives of physical medicine and rehabilitation 1 March 2008 (volume 89 issue 3 Pages S41-S46 DOI: 10.1016/j.apmr.2007.12.004)

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