A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome

Gertrud Kirchhoff,Miriam Lenz,Chlodwig Kirchhoff,Karl-Georg Kanz,Tobias Vogel,Rainer Kichhoff,Sonja Buhmann

doi:10.1186/1745-6673-1-14

Abstract

Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes.We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work.Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain.

Highlights

Chronic neck pain is widely prevalent and a common source of disability in the working-age population
We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine
The adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex

Summary

Background

Chronic neck pain is widely prevalent and a common source of disability in the working-age population. In approximately 95% of patients with neck pain account for category three presenting a benign diagnosis, for example neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain, pain due to degenerative changes as well as large osteophytes [3,4] Against this background, we present a highly interesting etiology for chronic neck pain, which might be underestimated in current research. The woman reported about severe neck pain, especially increasing over the last few months Her daily work was limited due to pain to a maximum of three hours daily. Conventional a-p and lateral cervical spine radiographs did not reveal major pathological findings within the spine, but a complete bilateral ossification of the stylohyoid ligaments (Figure 1 and 2). As the orthopaedic therapies, consisting of physical therapies as well as several courses of carbamazepine, baclofen, antidepressants and NSAID were ineffective the patient was presented to oral maxillofacial surgery for open resection of both ossified ligaments

Discussion

Findings

Summary

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