A 64-year-old man presents with a 3-month history of gradually increasing neck pain and stiffness.

The presentation is consistent with cervical spondylosis — a degenerative condition. In the absence of neurologic findings, further imaging beyond plain radiography is not warranted. Management includes conservative measures such as physiotherapy and analgesia.

Toronto Notes 2023 – Rheumatology, Cervical Spondylosis:

“Patients with typical cervical spondylosis and no red flags (e.g., neurologic deficits) do not require MRI. Treatment is conservative. Radiographs showing disc space narrowing and osteophytes confirm diagnosis.”

MCCQE1 Objectives – Internal Medicine > Musculoskeletal Disorders:

“Candidates must recognize typical degenerative spine disorders and avoid unnecessary investigations when clinical findings are straightforward.”

MRI (B) is useful if myelopathy or radiculopathy is suspected. CT (A), EMG (C), and LP (D) are not indicated here.

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