title: Brachioradial pruritus as a result of cervical spine pathology: the results of a magnetic resonance tomography study.
abstract: BACKGROUND
  Brachioradial pruritus (BRP) describes a rare form of itching occurring at the dorsolateral part of the forearms. Recent case reports suggest that BRP may be attributed to cervical lesions or spine neoplasms.
  
  
  OBJECTIVE
  We sought to determine the incidence of cervical spine changes in BRP and to correlate the localization of spinal lesions with the dermatomal presence of pruritus.
  
  
  METHODS
  Magnetic resonance tomography (MRT) of the cervical spinal cord, a chest x-ray, and a skin biopsy were performed in 41 patients (28 female, 13 male; 59.0 ± 10.6 years) with BRP. Patients completed an itch questionnaire (NeuroDerm Questionnaire) that included a dermatome chart and the Northwick Park Neck Pain Questionnaire.
  
  
  RESULTS
  The patients marked the locations C5 (90.2%) and C6 (100%) on the dermatome chart. All patients had detectable MRT changes. In 80.5% of the patients, stenosis of the intervertebral foramen or protrusions of the cervical disk led to nerve compression. The location of the nerve compression lesions correlated significantly with the dermatomal localization of the pruritus (Spearman correlation coefficient 0.893; P < .01). No spinal neoplasm was observed, and 19.5% of the patients had degenerative changes without significant correlation to the dermatomal localization of pruritus.
  
  
  CONCLUSIONS
  No healthy control group without pruritus was investigated.
  
  
  CONCLUSIONS
  BRP may result from cervical nerve compression, and rarely, it may also stem from degenerative changes. Our findings suggest that even slight cervical changes detected on MRT may alter itch afferents and lead to BRP. Spinal cord tumors are rare and should be ruled out by a cervical spine MRT.
authors.affiliation: Department of Neurology, University Hospital Münster, Münster, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Marziniak
authors.affiliation: Competence Center Pruritus and Department of Dermatology, University Hospital Münster, Münster, Germany.
authors.forename: Ngoc Quan
authors.initials: NQ
authors.lastname: Phan
authors.affiliation: Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Raap
authors.affiliation: Competence Center Pruritus and Department of Dermatology, University Hospital Münster, Münster, Germany.
authors.forename: Dorothee
authors.initials: D
authors.lastname: Siepmann
authors.affiliation: Competence Center Pruritus and Department of Dermatology, University Hospital Münster, Münster, Germany.
authors.forename: Funda
authors.initials: F
authors.lastname: Schürmeyer-Horst
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Esther
authors.initials: E
authors.lastname: Pogatzki-Zahn
authors.affiliation: Department of Clinical Radiology, University Hospital Münster, Münster, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Niederstadt
authors.affiliation: Competence Center Pruritus and Department of Dermatology, University Hospital Münster, Münster, Germany. Electronic address: sonja.staender@uni-muenster.de.
authors.forename: Sonja
authors.initials: S
authors.lastname: Ständer
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005542:Forearm / Q000000981:diagnostic imaging / Q000294:innervation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000150:complications; D011537:Pruritus / Q000209:etiology* / Q000473:pathology; D013122:Spinal Diseases / Q000150:complications*; D014057:Tomography, X-Ray Computed