{"id":4708,"date":"2025-05-12T00:04:24","date_gmt":"2025-05-11T22:04:24","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=4708"},"modified":"2025-05-15T17:20:44","modified_gmt":"2025-05-15T15:20:44","slug":"cervicalgie-avec-indice-de-suspicion-elevee","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=4708","title":{"rendered":"Cervicalgie avec indice de suspicion \u00e9lev\u00e9e"},"content":{"rendered":"\n<p><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">L&rsquo;indice de suspicion<\/h2>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p>Il n&rsquo;existe pas de red flag absolu. L&rsquo;indice de suspicion permet de se positionner pour savoir si on doit suspecter une pathologie grave et r\u00e9orienter ou non.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"573\" height=\"172\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-1.avif\" alt=\"\" class=\"wp-image-4745\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-1.avif 573w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-1-300x90.avif 300w\" sizes=\"auto, (max-width: 573px) 100vw, 573px\" \/><\/figure>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Fracture<\/h2>\n\n\n\n<p>Premi\u00e8re cause de fracture : AVP<\/p>\n\n\n\n<p>La Canadian C-Spine Rule permet de savoir si on doit faire une radio ou non. (tr\u00e8s bonne clinim\u00e9trie)<\/p>\n\n\n\n<p>Voir Cervicalgie &#8211; <a href=\"https:\/\/kineaphp.fr\/?p=4698\">R\u00e8gle de la C Spine<\/a><\/p>\n\n\n\n<figure class=\"wp-block-image size-large is-resized\"><a href=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/C-Spine-Rule-2.avif\"><img loading=\"lazy\" decoding=\"async\" width=\"821\" height=\"1024\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/C-Spine-Rule-2-821x1024.avif\" alt=\"\" class=\"wp-image-4699\" style=\"width:232px;height:auto\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/C-Spine-Rule-2-821x1024.avif 821w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/C-Spine-Rule-2-240x300.avif 240w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/C-Spine-Rule-2-768x958.avif 768w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/C-Spine-Rule-2.avif 1000w\" sizes=\"auto, (max-width: 821px) 100vw, 821px\" \/><\/a><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Les instabilit\u00e9s ligamentaires<\/h2>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<p>L\u00e9sion du ligament transverse qui prot\u00e8ge la ME du processus odonto\u00efde. En cas de suspicion : r\u00e9orienter vers le m\u00e9decin, voire les urgences<\/p>\n\n\n\n<p>Population \u00e0 risque :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patient avec la maladie Ether-Danlos (atteinte du tissus conjonctif)<\/li>\n\n\n\n<li>Post trauma (entorse ou ligament rompu)<\/li>\n\n\n\n<li>Chirurgie r\u00e9cente<\/li>\n<\/ul>\n\n\n\n<p>Diagnostic<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Signes subjectifs : difficult\u00e9s \u00e0 tenir la t\u00eate, sensation d&rsquo;instabilit\u00e9, bruits au niveau du cou<\/li>\n\n\n\n<li>Examen physique : extr\u00eame mobilit\u00e9<\/li>\n\n\n\n<li><a href=\"https:\/\/youtu.be\/8Q8vzFb2FUM?si=DhsB91HpSPl4cg0Z\" target=\"_blank\" rel=\"noreferrer noopener\">Test Sharp Purser<\/a> : maintien du processus \u00e9pineux de C2 et flexion puis extension cervicale du patient. Test positif en cas de ressaut. <\/li>\n<\/ul>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"231\" height=\"185\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-5.avif\" alt=\"\" class=\"wp-image-4762\"\/><\/figure>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Dysfonctions art\u00e9rielles<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Dissection art\u00e9rielle si trauma r\u00e9cent<\/li>\n\n\n\n<li>Occlusion art\u00e9rielle si FDR cardio-vasculaire (s\u00e9dentarit\u00e9, alcool, tabac)<\/li>\n\n\n\n<li>Examen physique peu fiable<\/li>\n<\/ul>\n\n\n\n<p>Anamn\u00e8se : 5D 3N 1A (urgence)<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>5D : Diplopie, Dysphagie, Drop attack, Dizziness, Dysarthrie<\/li>\n\n\n\n<li>3N : Naus\u00e9e, Nystagmus, Numbness (engourdissement surtout au visage)<\/li>\n\n\n\n<li>1A : Ataxie<\/li>\n<\/ul>\n\n\n\n<p>1 signe : urgence<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">My\u00e9lopathie<\/h2>\n\n\n\n<p>R\u00e9tr\u00e9cissement au niveau du cordon m\u00e9dullaire -> compression de la ME<\/p>\n\n\n\n<p>R\u00e8gle de pr\u00e9diction de Cook<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u00c2ge > 45 ans<\/li>\n\n\n\n<li>Anomalie de la marche : chute, marche d\u00e9vi\u00e9e, besoin de s&rsquo;asseoir<\/li>\n\n\n\n<li>Hyperr\u00e9flexie : Hoffman, Babinski, supinateur invers\u00e9 positif<\/li>\n<\/ul>\n\n\n\n<p>2 signes -> r\u00e9orienter<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">N\u00e9vralgies amyotrophiantes<\/h2>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<p>Ex : Parsonage Turner<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Douleur violente d&rsquo;apparition \u00e0 l&rsquo;\u00e9paule<\/li>\n\n\n\n<li>Suivie d&rsquo;une paralysie et d&rsquo;une amyotrophie<\/li>\n\n\n\n<li>Muscles de la ceinture scapulaire et parfois distaux<\/li>\n\n\n\n<li>Recherche d&rsquo;un \u00e9pisode viral : les probl\u00e8mes viraux peuvent amener \u00e0 des probl\u00e8mes nerveux<\/li>\n<\/ul>\n\n\n\n<p>-&gt; redirection<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<figure class=\"wp-block-image size-full is-resized\"><a href=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-3.avif\"><img loading=\"lazy\" decoding=\"async\" width=\"179\" height=\"338\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-3.avif\" alt=\"\" class=\"wp-image-4759\" style=\"width:108px;height:auto\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-3.avif 179w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-3-159x300.avif 159w\" sizes=\"auto, (max-width: 179px) 100vw, 179px\" \/><\/a><\/figure>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">M\u00e9tastase m\u00e9dullaire<\/h2>\n\n\n\n<p>Syndromes centraux en lien avec l&rsquo;alt\u00e9ration de l&rsquo;\u00e9tat g\u00e9n\u00e9ral. Les m\u00e9tastases osseuses thoraciques sont tr\u00e8s souvent les premiers foyers osseux des m\u00e9tastases<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">Pancoast-Tobias<\/h2>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p>Tumeur de l&rsquo;apex pulmonaire. Quand elles grossissent, elles peuvent comprimer le bas du plexus brachial et donner des syndromes radiculaires (C8-T1)<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"177\" height=\"179\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-2.avif\" alt=\"\" class=\"wp-image-4758\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-2.avif 177w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/05\/image-2-80x80.avif 80w\" sizes=\"auto, (max-width: 177px) 100vw, 177px\" \/><\/figure>\n<\/div>\n<\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>L&rsquo;indice de suspicion Il n&rsquo;existe pas de red flag absolu. L&rsquo;indice de suspicion permet de se positionner pour savoir si on doit suspecter une pathologie grave et r\u00e9orienter ou non. Fracture Premi\u00e8re cause de fracture&hellip;<\/p>\n<p class=\"more-link-wrapper\"><a href=\"https:\/\/kineaphp.fr\/?p=4708\" class=\"more-link\">Continue Reading<span class=\"screen-reader-text\"> \u00ab\u00a0Cervicalgie avec indice de suspicion \u00e9lev\u00e9e\u00a0\u00bb<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[374],"tags":[],"class_list":["post-4708","post","type-post","status-publish","format-standard","hentry","category-pathologie-cervicales"],"_links":{"self":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/4708","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4708"}],"version-history":[{"count":10,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/4708\/revisions"}],"predecessor-version":[{"id":4767,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/4708\/revisions\/4767"}],"wp:attachment":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4708"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4708"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4708"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}