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 .
Reproducibility of cervical range of motion in patients with neck pain
Background Reproducibility measurements of the range of motion are an important prerequisite for the interpretation of study results . The aim of the study is to assess the intra-rater and inter-rater reproducibility of the measurement of active Range of Motion ( ROM ) in patients with neck pain using the Cybex Electronic Digital Inclinometer-320 ( EDI-320 ) . Methods In an outpatient clinic in a primary care setting 32 patients with at least 2 weeks of pain and /or stiffness in the neck were r and omly assessed , in a test- retest design with blinded raters using a st and ardized measurement protocol . Cervical flexion-extension , lateral flexion and rotation were assessed . Results Reliability expressed by the Intraclass Correlation Coefficient ( ICC ) was 0.93 ( lateral flexion ) or higher for intra-rater reliability and 0.89 ( lateral flexion ) or higher for inter-rater reliability . The 95 % limits of agreement for intra-rater agreement , expressing the range of the differences between two ratings were -2.5 ± 11.1 ° for flexion-extension , -0.1 ± 10.4 ° for lateral flexion and -5.9 ± 13.5 ° for rotation . For inter-rater agreement the limits of agreement were 3.3 ± 17.0 ° for flexion-extension , 0.5 ± 17.0 ° for lateral flexion and -1.3 ± 24.6 ° for rotation . Conclusion In general , the intra-rater reproducibility and the inter-rater reproducibility were good . We recommend to compare the reproducibility and clinical applicability of the EDI-320 inclinometer with other cervical ROM measures in symptomatic patients
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 .