Open AccessDisabling Pruritus in a Patient With Cervical Stenosis
Author(s) -
Stephan N. Salzmann,
Ichiro Okano,
Jennifer Shue,
Alexander P. Hughes
Publication year - 2020
Publication title -
journal of the american academy of orthopaedic surgeons. global research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.358
H-Index - 2
ISSN - 2474-7661
DOI - 10.5435/jaaosglobal-d-19-00178
Subject(s) - medicine , itching , neck pain , surgery , etiology , spinal cord compression , cervical spondylosis , stenosis , malignancy , spinal cord , radiology , pathology , alternative medicine , psychiatry
Brachioradial pruritus is a rare condition characterized by chronic localized itching of the dorsolateral upper extremities. Although the exact pathophysiology is still unknown, cervical nerve compression is thought to be a cause. We present the case of a 56-year-old man with a 6-year history of disabling chronic bilateral upper extremity pruritus and pain as well as concurrent neck pain. The patient presented to our office after multiple inconclusive diagnostic evaluations (dermatology, rheumatology, neurology, and psychiatry) and unsatisfactory multimodal conservative treatment attempts. His symptoms markedly impeded his ability to get restful sleep. Imaging of the cervical spine revealed multilevel cervical spondylosis, spinal stenosis with cord compression, and multilevel foraminal stenosis. The patient underwent successful multilevel anterior cervical decompression and fusion and was instantly symptom-free. The present case highlights that patients complaining of itching of the dorsolateral forearms of seemingly unknown etiology should undergo a workup of the cervical spine. If conservative treatment fails, surgical decompression may be considered in select patients.