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 .
Mechanical performance and electromyography during repeated maximal isokinetic shoulder forward flexions in female cleaners with and without myalgia of the trapezius muscle and in healthy controls
Abstract This cross-sectional study aim ed at investigating the influence of occupational exposure to static and highly repetitive work involving the neck and shoulder muscles , myalgia of and tender point in the trapezius muscle on biomechanical output , and electromyogram ( EMG ) variables ( mean frequency MNF , signal amplitude and ability to relax ) during maximal forward flexions of the shoulder muscles . Groups of 25 cleaners suffering from chronic myalgia of the trapezius muscle , 25 cleaners free from myalgia of the trapezius muscle and 21 teachers performed 150 forward flexions using an isokinetic dynamometer .  Perception of fatigue was reported and surface EMG was recorded from four muscles during the endurance test . The cleaners were stronger than the teachers . Myalgia was associated with lower levels of endurance and a high degree of perceived fatigue . The ability to relax the trapezius muscle decreased with age and was even lower in cleaners with and without myalgia . Higher MNF of the deltoid muscle but not of the trapezius muscle was found in the group suffering from myalgia compared to the groups free from myalgia . This cross-sectional study indicated that myalgia of the trapezius muscle did not influence the strength but did influence the endurance of the forward flexor muscles of cleaners . The observed decrease in the ability to relax the trapezius muscle in cleaners compared to healthy teachers might be indicative of a future insufficiency in the muscle . Prospect i ve studies are needed to define the significance of the results presented here
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 .