Thank you for the additional information. With regard to your MS, do you feel any intense itching in the neck region that is bothering you? If so, which side (or both) do you feel the itching?
First and foremost, I would want you to make sure you have regular follow-up with your MS physician, as signs and symptoms of this condition are widely variable and help your physician to properly recognise any relapses or progression of the condition. Intense itching, which could also be perceived as a discomfort, can be a sign of the radicular or sensory changes involved in MS.
With this going on for 5 months now, I do have concerns that take what you describe out of the realm of usual and common conditions that we see day in and day out. Evaluation for relapse or progression of the MS is very important, and I do recommend that you see you MS Neurologist to have things evaluated.
There is one bone in the front of the neck, called the hyoid bone. The main bump or protruding bone-like anatomy that we tend to feel most readily in our neck is the thyroid cartilage. In men, it's larger and often referred to as the Adam's Apple. There are also numerous segments of cartilage in the remainder of the trachea (windpipe) that are able to be touched and examined along the front of the neck, just below the thyroid cartilage. Cartilage can become inflammed, and when this occurs we call it chondritis.
There is a condition, called Relapsing Polychondritis, and when it affects the large airways it is often accompanied by a non-productive (dry) cough and tenderness over the thyroid cartilage and trachea (windpipe) region in the anterior (front of the) neck. Sometimes there are secretions in the upper airway, but they are tenacious and difficult to clear, much as you describe. The best physician to evaluate the tenderness of your thyroid cartilage and possibly the anterior trachea cartilages, as well as the upper airway, is an Ear, Nose, and Throat Surgeon ... often just called ENT Physician (also known as an Otorhinolaryngologist, but that's just too long to have anyone say!). I would also want for you to feel other areas that have cartilage for tenderness, such as the ears, eyes, nose, and joints.
Relapsing polychondritis can be a serious condition. It is immune-mediated, and is associated with other auto-immune and immune-mediated inflammatory conditions. If this diagnosis is indeed confirmed by ENT Surgery, then you will need a fairly extensive evaluation by a Rheumatologist and Internal Medicine physician because of the frequent involvement of organs and tissues falling into these specialists realm. One step at a time, though. I am explaining to you my entire ideas and systematic evaluation process based on multiple "what if" scenarios. We need to begin with a thorough ENT evaluation for large airway tracheolaryngeal and thyroid cartilage chondritis first. The ENT will also be able to advise regarding the difficulty in clearing your throat and the persistent non-productive, dry cough in the event this isn't chondritis.
As with any sensory changes, including neck pain or itching, I would want you to Follow-up with your MS Neurologist to make sure this is not a manifestation of relapse or progression of the MS.
ENT Consultation to evaluate the tenderness you feel in the neck, which sounds like thyroid cartilage "chondritis" (cartilage inflammation). This could be a symptom of a much larger concern, called Relapsing Polychondritis, which is associated with autoimmune (like MS) and immune-mediated inflammatory conditions. The ENT will also be able to evaluate the non-productive cough and difficulty clearing your throat, which can be a sign of Polychondritis, among other things. Remeber to feel your ears, nose, joints, and look at the whites of your eyes for any "salmon" coloured patches ... as tenderness or signs of colour change on the sclerae (the whites of the eyes) are also signs of Polychondritis. If the ENT feels this is not chondritis, then he or she will have recommendations otherwise.
If Polychondritis is a concern, a multidisciplinary team of doctors will need to evaluate you for associated conditions. The doctors that evaluate Polychondritis that I would recommend would best be Rheumatology and Internal Medicine ... sometimes both work together.
Print this page out and take it with you to your appointments. That way, the physicians will understand better my language and concerns.
My duty to you is to make sure you are well informed. The most important information has been passed along, and to be honest, I implore you to make sure and follow-up with Neurology and ENT to start things moving. It's a difficult thing to try to wrap everything up in a tidy little package over the Internet, but I need to make sure for your sake that nothing bad slips past my thoughts or that forget to tell you something. Hence, I am being a bit lengthy in describing to you all of this information in this reply. I want you to be safe, more than anything.
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