Screening protocol s have high predictive values to detect cervical spine fracture in alert , low-risk patients seeking emergency care after blunt neck trauma .
Computerized tomography ( CT ) scans had better validity ( in adults and elderly ) than radiographs in assessing high-risk and /or multi-injured blunt trauma neck patients .
In the absence of serious pathology , clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression .
One exception is the manual provocation test for cervical radiculopathy , which has high positive predictive value .
There was no evidence that specific MRI findings are associated with neck pain , cervicogenic headache , or whiplash exposure .
No evidence supports using cervical provocative discography , anesthetic facet , or medial branch blocks in evaluating neck pain .
Reliable and valid self-report question naires are useful in assessing pain , function , disability , and psychosocial status in individuals with neck pain .
CONCLUSION The scientific evidence supports screening protocol s in emergency care for low-risk patients ; and CT-scans for high-risk patients with blunt trauma to the neck .
In nonemergency neck pain without radiculopathy , the validity of most commonly used objective tests is lacking .
OBJECTIVE To critically appraise and synthesize the literature on assessment of  neck pain .
SUMMARY OF BACKGROUND DATA The published literature on assessment of neck pain is large and of variable quality .
There have been no prior systematic review s of this literature .
Chemokines and Their Receptors in Whiplash Injury: Elevated RANTES and CCR-5
The human sufferings and socioeconomic burden due to whiplash-associated disorders ( WAD ) are obvious but the pathogenesis of WAD is obscure . The possible involvement of the immune system during the disease process in WAD is not known . Effector molecules including chemokines and their receptors could play a role in WAD . In a prospect i ve study using flow cytometry , we examined percentages of blood mononuclear cells ( MNC ) expressing the chemokines RANTES , MCP-1 , MIP-1α , MIP-1β , and IL-8 , the chemokine receptor CCR-5 , the T cell activation marker CD25 , and the T cell chemoattractant IL-16 in patients with WAD and , for reference , in healthy controls . Higher percentages of RANTES-expressing blood MNC and T cells were observed in patients with WAD examined within 3 days compared to 14 days after the whiplash injury and , likewise , compared with healthy controls . The patients with WAD examined within 3 days after the accident also had higher percentages of CCR-5-expressing blood MNC , T cells , and CD45RO+ T cells compared to healthy controls . In contrast , there were no differences for any of these variables between patients with WAD examined 14 days after injury and healthy controls . In conclusion , WAD is associated with a systemic but transient dysregulation in percentages of RANTES and CCR-5 expressing MNC and T cells
Screening protocol s have high predictive values to detect cervical spine fracture in alert , low-risk patients seeking emergency care after blunt neck trauma .
Computerized tomography ( CT ) scans had better validity ( in adults and elderly ) than radiographs in assessing high-risk and /or multi-injured blunt trauma neck patients .
In the absence of serious pathology , clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression .
One exception is the manual provocation test for cervical radiculopathy , which has high positive predictive value .
There was no evidence that specific MRI findings are associated with neck pain , cervicogenic headache , or whiplash exposure .
No evidence supports using cervical provocative discography , anesthetic facet , or medial branch blocks in evaluating neck pain .
Reliable and valid self-report question naires are useful in assessing pain , function , disability , and psychosocial status in individuals with neck pain .
CONCLUSION The scientific evidence supports screening protocol s in emergency care for low-risk patients ; and CT-scans for high-risk patients with blunt trauma to the neck .
In nonemergency neck pain without radiculopathy , the validity of most commonly used objective tests is lacking .
OBJECTIVE To critically appraise and synthesize the literature on assessment of  neck pain .
SUMMARY OF BACKGROUND DATA The published literature on assessment of neck pain is large and of variable quality .
There have been no prior systematic review s of this literature .