DOI: https://doi.org/10.22263/2312-4156.2026.1.93
V.V. Yangolenko1, M.V. Niahurka2, T.V. Tsimafeyeva2, I.V. Hrabennikava2, T.M. Liarskaya2, E.A. Naidzionava2
Multidisciplinary approach to diagnosis and treatment of neck pain
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus
Vestnik VGMU. 2026;25(1):93-99.
Abstract.
Neck pain is a common reason for seeking medical attention. The true cause of neck pain is difficult to determine without a comprehensive examination of a patient, especially if the pain is acute, not caused by a neck injury, and is accompanied by soft tissue swelling and fever. Spontaneous soft tissue hematoma of the neck is a rare condition that occurs without apparent external influences or risk factors and may require emergency surgery due to the potential for compression of the common carotid artery, internal jugular vein, and trachea, as well as the probability of asphyxia.
The causes and clinical manifestations of spontaneous neck hematomas include severe pain, shortness of breath, rapidly growing neck swelling, odynophagia, and dysphagia. These manifestations are similar to those typical of such diseases as acute purulent thyroiditis, subacute thyroiditis, subcutaneous emphysema of the neck, and Quincke’s edema. This article describes the clinical presentation, possible causes, and course of the disease, as well as a differential diagnosis algorithm for diseases with similar clinical symptoms, as well as emergency care and drug treatment for a patient with spontaneous neck soft tissue hematoma. The article substantiates the need for a multidisciplinary approach to the diagnosis and treatment of spontaneous hematoma of the neck soft tissues involving such specialists as an endocrinologist, allergist, surgeon, dentist, otolaryngologist, using modern diagnostic methods of ultrasound examination and computed tomography with contrast enhancement for diagnosis, dynamic monitoring of the development of the disease and for deciding on the need and urgency of surgical treatment of spontaneous hematoma of the neck due to the possibility of complications and threat to the patient’s life.
Keywords: spontaneous hematoma, hemorrhage into the thyroid gland, subcutaneous emphysema, Quincke’s edema, acute purulent thyroiditis, subacute thyroiditis, nodular goiter
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Submitted 03.11.2025
Accepted 16.02.2026
Information about authors:
Vera V. Yangolenko – Candidate of Medical Sciences, associate professor of the Chair of Hospital Therapy and Cardiology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University; e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
M.V. Niahurka – head of the endocrinology department, Vitebsk Regional Clinical Hospital;
T.V. Tsimafeyeva – endocrinologist of the endocrinology department, Vitebsk Regional Clinical Hospital;
I.V. Hrabennikava – endocrinologist of the endocrinology department, Vitebsk Regional Clinical Hospital;
T.M. Liarskaya – radiologist of the X-ray computed unit, Vitebsk Regional Clinical Hospital;
E.A. Naidzionava – head of the department of ultrasound diagnostics, Vitebsk Regional Clinical Hospital.
