A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome

We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work.Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain.Chronic neck pain is widely prevalent and a common source of disability in the working-age population. The clinical picture includes stiffness and/or pain in the dorsal cervical region between the occipital condyles and the vertebral prominence of C7 [1]. Several studies have shown significantly reduced range of cervical movement and therefore a high rate of work disability followed by yearly accumulating cost for the compensation by insurance carriers.Many researchers have tried to classify neck pain and many different methods have been proposed. The best and most widely accepted method of classification for neck pain is diagnostic triage, where patients are categorized as falling into one of three groups: serious spinal pathology; neurological involvement; and non-specific neck pain.In the less number of cases, neck pain is caused by tumours, systemic arthropathy (e.g. rheumatoid arthritis, ankylosing spondylitis), infectious diseases, disorders of the thyroid gland, oesophageal obstruction or reflux disease [2]. Yet, in approximately 95% of patients with neck pain account for category three presenting a benign diagnosis, for example neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain, pain d