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Clinical Problem Solving: Radiology
Sep 2011

Radiology Quiz Case 1

Author Affiliations
 

SECTION EDITOR: C. DOUGLAS PHILLIPS, MD

Arch Otolaryngol Head Neck Surg. 2011;137(9):953. doi:10.1001/archoto.2011.148-a

A 39-year-old man presented to the emergency department with a 3-day history of worsening pain in the posterior aspect of his neck that was exacerbated by neck movement. He complained of odynophagia but no alteration of voice.

On physical examination, the patient's vital signs included low-grade pyrexia with mild tachycardia. He was alert and oriented. Nuchal rigidity and pain were elicited with passive and active neck extension and flexion. There was no evidence of cervical lymphadenopathy or papilledema. Blood analysis demonstrated an elevated white blood cell count, with neutrophil predominance. The levels of inflammatory markers (C-reactive protein and erythrocyte sedimentation rate) were moderately elevated.

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