Bilateral foot numbness

Chief complaint: Neck pain and headaches

History of Present Illness:

A 62-year-old slightly obese female with a history of neck pain, headaches and hyperlipidemia complains of fatigue and lack of energy.

Review of Systems revealed a 20-year history of smoking, long-term statin drug use, and no supplementation. She is sedentary and has a family history of high blood pressure.

VITALS: Temp 97.8, Pulse 66, RR 20, BP 160/101

Pertinent Findings: 5’10”, 263 lbs, moderately obese woman with excess body fat around the waist. All active cervical ranges of motion were slightly limited with pain. Shoulder depression caused a stretching feeling bilaterally. All other orthopedic and neurologic tests were negative. A blood test was performed to examine cholesterol levels.

Create a problem list for this patient, considering the patient’s presentation but not the results of any further diagnostic studies.

Create an initial differential diagnosis list for the major problem of this patient (bilateral foot numbness) in the table below. For each item on the differential diagnosis, list items that either support the diagnosis or make it less likely.