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Can Cervical degeneration be due to HIV+?
Dec 7, 2012

Dear Doc, Over the course of the summer, I have suffered with lower back, hip, knee, and ankle pain, along with tingling and numbness. My doc sent me for a nerve conduction test and then to a neurologist. Neurologist found that I have peroneal neuropathy at the right knee, lateral femoral cutaneous nerve syndrome through the abdomen, and tardy ulnar palsy of the left arm. My primary care doc says that all this is due to HIV+ -- I tested negative to diabetes. But I don't really buy the story of HIV+ causing all these problems. In the last few months, I have been experiencing numbness in the left arm in the last 2 fingers (and maybe the middle one also sometimes, its hard to tell) and neck pain that radiates and goes into both shoulder blades. It was bothering me so bad, I finally went to ER last week over it. A simple x-ray had the following findings. Can you tell me what it means and if HIV+ could be the cause? I will be following up with primary care doc, but she is out of the office until after the first of the year-- do I need to try and see another doc in the meantime? X-ray findings: Examination: Cervical spine without obliques 3 views.

Clinical Information: Neck pain.

Findings: The lateral view shows reversal of the cervical lordosis. There is significant C6-C7 disc narrowing with anterior and posterior hypertrophic change. There no fractures, subluxations or lytic bonelesions. The odontoid process is intact. Impression: 1. 5+ C6-C7 degenerative disc disease. 2. Muscle spasm.

The ER doc put me on 4,000 mg Robaxin/day with the assumption I would immediately follow up with my primary care doc...unfortunately she is out of the office until after the new year. Can you tell me what these findings mean, and if I should seek care of another doc until mine comes back into the offic? Thanks

Response from Dr. Henry

You dont provide many key details such as what is your current and past HIV regimen, current age and weight, histdory of AIDS related conditions, current and past CD4 counts and viral loads, other medical problems, exam findings. HIV is not usually the cause of localized nerve impingement with cervical disc disease (that condition is fairly common in general population). HIV related peripheral neuropathy usually involves peripheral nerves starting in toes/feet. There are some much less common spinal cord problems often linked to more advanced and/or untreated disease. KH



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