- SlidesCaseload 3Cervical PIV (Posterior Intervertebral) Joint DysfunctionThe one neck pattern where a structure is genuinely identifiable — and the only way anyone has ever identified it is with a needle. The hands beat the scan here, which is rare and worth knowing, but the best clinical sign rules the joint out better than it rules one in, and the movement rule every student is taught has never been measured by anybody.
- SlidesCaseload 4Whiplash-Associated Disorder (WAD)The pattern where the subjective carries almost the whole reasoning load and the objective examination is a safety check plus a baseline. Australia has a real guideline for this one - one of the few patterns here with a national document covering diagnosis, prognosis, treatment and assessment in both acute and chronic stages. About half of these people still report neck pain at a year, recovery happens in the first three months and then flattens, and what predicts the outcome is initial pain, initial disability, post-traumatic stress and their own expectation - not the crash.
- SlidesCaseload 8Cervical Radiculopathy (Cervical Radicular Pain)The arm-dominant branch of the neck triage, and the mirror image of its lumbar sibling: the clinical tests here are genuinely good and the treatment evidence is close to empty. All four ULNTs negative makes it much less likely, a cluster rules it in when it fires and it fires rarely, and the biggest management review found 59 trials and could not pool a single outcome.
- SlidesCervical Arterial DysfunctionThe test you were taught has a negative likelihood ratio that can exceed 1.0. The decision was always in the history — and pain comes hours to days before the neurology.
- SlidesCervical Discogenic Pain (axial disc-attributed neck pain)The pattern where the reasoning has to be honest about itself. The cervical disc can hurt — the anatomy and the provocation studies settle that. What nobody has shown is that you can find it in front of a patient: no physical test has measured accuracy, the reference standard has been downgraded twice by the same authors on the same three studies, and the joint next door is three times as common and has a validated examination.
- SlidesCervical Instability (Functional and Upper Cervical Ligamentous)Recurrent neck pain with a sense of the neck hinging or catching mid-movement. A contested label doing real work here, and how to tell it from the upper cervical problem you must not miss.
- SlidesCervical Postural / Mechanical Neck PainThe pattern you will see most, and the one usually taught structurally right and mechanistically wrong. The body chart makes the diagnosis, posture does not cause it, every accuracy number in this literature belongs to a neighbouring pattern, and the prognosis is worse than students are taught.
- SlidesCervicogenic HeadacheA secondary headache - pain generated at C1-C3 and referred to the head. The trap is that three quarters of migraine patients also carry a stiff, tender, forward-headed neck, so the neck exam confirms nothing on its own. One test has usable numbers, the two criteria sets disagree with each other, and the honest student note says 'consistent with', never 'diagnosis'.
- SlidesCluster HeadacheYou will not treat this, and you may be the person who finally names it. Strictly one-sided orbital pain in bouts, with a red eye and a drooping lid — and why the referral is urgent.
- SlidesDegenerative Cervical MyelopathyMissed for years, and the mechanism of the miss is a physiotherapy-shaped problem: no gait test, an incomplete neurological exam, and an EMG ordered to chase a peripheral neuropathy.
- SlidesMigraineOne-sided throbbing headache with nausea and light sensitivity, worse for moving. You won't cure it — and there are three things you can do that genuinely matter.
- SlidesTemporomandibular Disorders (TMD)Jaw and temple ache with clicking on opening, worse with clenching and long conversations. Common, mostly self-limiting, and full of things students do that don't help.
- SlidesTension-Type HeadacheBilateral band-like pressing head pain, no nausea, not worse for stairs. The most common primary headache, and the one students manage without asking the two questions that matter.
This is a learning tool. It does not diagnose patients and does not replace your clinical educator.
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