DIAGNOSIS AND MaNAGEMENT OF BRACHIalgia

Abstract

Brachialgia is the radiating pain to the upper extremity or occipital area of the skull and is referred to one or more dermatome with or without tenderness in the muscle of the involved nerve root, there is aparaesthesia, numbness, sensory loss, disturbance of reflexes of upper extremity.

It is caused by many disorders of the cervical vertebrae and the thoracic outlet through compression of the brachial plexus and blood vessels.

The most common causes ofbrachialgia are cervical spondylosis, cervical prolapsed disc, cervical spondylotic myelopathy, thoracic outlet syndrome, carpal tunnel syndrome and syringomyelia. The diagnostic techniques compasses Radio and electrodiagnosis.

The Radiodiagnosis includes X-ray, plain myelogram, CT, CTM, MRI and radionuclear bone scan, x-ray is done routinely for cervical spine and chest to detect the cervical rib, long C7 transverse process, first

rib anomalies, fracture calvicle callus, tumour involving the thoracic outlet, narrowed cervical disc, degenerative cervical· arthritis, osteophytes and narrowed intervertebral foramena.

Other diagnostic imaging studies with an ability to visualize neural tissue or intervertebral disc are used to assess nerve root compression; these modalities include myelography, CT, CTM and MRI. CT can allow direct visualization of the neural compressing structures, in contrast to