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 .
Head position and impact direction in whiplash injuries: associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine.
In the present study , we compared magnetic resonance imaging ( MRI ) findings of soft tissue structures in the upper cervical spine between whiplash-associated disorder ( WAD ) patients and population -based control persons , and examined whether MRI-verified abnormalities in WAD patients were related to accident-related factors hypothesized to be of importance for severity of injury . A total of 92 whiplash patients and 30 control persons , r and omly drawn , were included . Information on the accident-related factors ( i.e. , head position and impact direction ) was obtained by a question naire that was answered within 1 week after the accident . The MRI examination was performed 2 - 9 ( mean 6 ) years after the accident . Focus was on MRI abnormalities of the alar and the transverse ligaments , and the tectorial and posterior atlanto-occipital membranes , grade d 0 - 3 . For all neck structures , the whiplash patients had more high- grade lesions ( grade 2 or 3 ) than the control persons ( Chi-square test , p < 0.055 ) . An abnormal alar ligament was most common ( 66.3 % grade d 2 or 3 ) . Whiplash patients who had been sitting with their head/neck turned to one side at the moment of collision more often had high- grade lesions of the alar and transverse ligaments ( p < 0.001 , p = 0.040 , respectively ) . Severe injuries to the transverse ligament and the posterior atlanto-occipital membrane were more common in front than in rear end collisions ( p < 0.001 , p = 0.001 , respectively ) . In conclusion , the difference in MRI-verified lesions between WAD patients and control persons , and in particular the association with head position and impact direction at time of accident , indicate that these lesions are caused by the whiplash trauma
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 .