【PhD Win Medical Case】We can know from neck pain of the medical case that diagnosis and treatment do not depend on the MRI, It more important to do examination with hands

2, He felt too much pain in neck and shoulders in 27/09/2022, so he went to the Auckland hospital, the X-ray report the neck spine is normal,  and  the doctor Physical Examination*
· Vital signs:
HR 81, BP 138/60, RR 17, Sats 100%0A Temp 36.6C
· General:
Appears well from end of bed but in obvious discomfort especially when moving neck
WWP
Able to flex, extend and rotate neck but limited by pain, L>R
· CNS:
· Alert, oriented to time place and person
· Cranial nerves 11-IIX normal
· Peripheral tone normal
· Sensation normal
· Power normal
Upper limb power 5/5 bilaterally

4, And he went to specialist in spine in 17/10/2022, and the MRI report： MRI of the cervical spine shows a left-sided C5 and C6 nerve root compression at the C4-5 and
C5-6 foramen. He also has right sided C6 nerve root compression at the C5-6 foramen. No spinal cord compression and no spinal cord signal change.

And the specialist examination: He is of normal BMI. He walks with a normal gait. He was able to heel and toe walk. Tandem gait was intact. He had a full range of motion of the cervical spine with pain at the extremes of rotation and lateral flexion. Neurologically he had 5 out of 5 motor strength in bilateral upper extremities except for 4+ out of 5 elbow flexion and wrist extension, C5 and C6 myotomes. Sensation was intact bilaterally. Reflexes were symmetrical. Hoffman’s was negative. Lhermitte’s and Spurling’s were negative.

     2) Sensation was intact bilaterally upper limbs

     3) Reflexes were symmetrical upper limbs