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 .
Gd-DTPA-enhanced 3D MR imaging of cervical degenerative disk disease: initial experience.
PURPOSE To assess whether a single enhanced T1-weighted gradient echo volume sequence , with the appropriate reformatted images , could be equivalent to a more conventional 2D set of MR sequences for the evaluation of cervical extradural degenerative disk disease ( bony canal and foraminal stenosis ; disk herniation ) . MATERIAL S AND METHODS Sixty-one patients evaluated for extradural degenerative disease by MR were imaged with a " st and ard " MR examination ( Sagittal T1-weighted spin echo , axial low flip angle gradient echo ) , were then given 0.1 mmol/kg Gd-DTPA intravenously , and reimaged with either a 3D FLASH ( fast low angle shot ) , TR 40/TE 7/1 excitation ) , 40 degree flip angle , acquired as 64 , 2-mm sagittal partitions , or a 3D turbo FLASH ( MP RAGE-magnetization prepared rapid acquisition gradient echo ) ( 10/4/1 ) , 10 degree flip angle acquired as 128 , 2-mm coronal partitions . The volume sequences were reconstructed in the axial plane , and right and left 45 degree oblique coronal planes . The two sets of examinations ( st and ard vs volume ) were prospect ively interpreted by two neuroradiologists for quality of examination , and location , type , and severity of extradural degenerative disease in a r and om , blinded , independent fashion . RESULTS There was no significant difference between the st and ard examination and the 3D MP RAGE for central extradural disease . The 3D FLASH examination was significantly worse than the st and ard examination in identification of central extradural disease , with an average of 21 herniations not identified , or underestimated in size . Neither the 3D FLASH , nor the 3D MP RAGE examinations showed any significant improvement compared to the routine 2D examination for the location and severity of foraminal disease . CONCLUSION If extradural degenerative disk disease is being evaluated , then a single enhanced 3D T1-weighted imaging sequence taking 6 minutes can be equivalent to a routine set of mixed 2D spin echo and low flip angle gradient echo sequences
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 .