For example, in a study of 22 symptomatic and 20 control patients, there was no difference in the number of patients with cervical disc bulges or in the distribution of degenerative disc disease within the cervical spine [104]. Myelography Cervical Spine In the absence of radiographic abnormalities or neurological symptoms, myelography is not an appropriate first- line imaging test. CT Cervical Spine CT is not currently recommended as a first-line examination for chronic neck pain in the absence of red flags or neurological symptoms. CT Myelography Cervical Spine CT myelography is not an appropriate test for chronic neck pain in the absence of radicular or myelopathic symptoms. CTA Neck The literature search did not identify any studies regarding the use of CTA in the evaluation of this clinical presentation. Percutaneous Interventions The literature search did not identify any studies regarding the use of cervical facet joint, medial branch blocks, or discography as a first-line test in the evaluation of this clinical presentation. MRA Neck The literature search did not identify any studies regarding the use of MRA in the evaluation of this clinical presentation. MRI Cervical Spine MRI is the most sensitive test for detecting soft abnormalities associated with neck pain; however, it is characterized by a high rate of abnormalities in asymptomatic individuals [22,23]. As such, MRI is not considered appropriate as a first-line imaging modality in the setting of chronic, uncomplicated neck pain. Bone Scan Whole Body with SPECT or SPECT/CT Neck The role of Tc-99m bone scan in the setting of chronic neck pain is limited, though SPECT likely offers benefit over conventional planar imaging. Some authors have advocated SPECT imaging in identifying the pain source (ie, facet disease) [106]; however, is not considered appropriate as a first imaging modality in the setting of chronic, uncomplicated neck pain.
Cervical Neck Pain or Cervical Radiculopathy PCAs. For example, in a study of 22 symptomatic and 20 control patients, there was no difference in the number of patients with cervical disc bulges or in the distribution of degenerative disc disease within the cervical spine [104]. Myelography Cervical Spine In the absence of radiographic abnormalities or neurological symptoms, myelography is not an appropriate first- line imaging test. CT Cervical Spine CT is not currently recommended as a first-line examination for chronic neck pain in the absence of red flags or neurological symptoms. CT Myelography Cervical Spine CT myelography is not an appropriate test for chronic neck pain in the absence of radicular or myelopathic symptoms. CTA Neck The literature search did not identify any studies regarding the use of CTA in the evaluation of this clinical presentation. Percutaneous Interventions The literature search did not identify any studies regarding the use of cervical facet joint, medial branch blocks, or discography as a first-line test in the evaluation of this clinical presentation. MRA Neck The literature search did not identify any studies regarding the use of MRA in the evaluation of this clinical presentation. MRI Cervical Spine MRI is the most sensitive test for detecting soft abnormalities associated with neck pain; however, it is characterized by a high rate of abnormalities in asymptomatic individuals [22,23]. As such, MRI is not considered appropriate as a first-line imaging modality in the setting of chronic, uncomplicated neck pain. Bone Scan Whole Body with SPECT or SPECT/CT Neck The role of Tc-99m bone scan in the setting of chronic neck pain is limited, though SPECT likely offers benefit over conventional planar imaging. Some authors have advocated SPECT imaging in identifying the pain source (ie, facet disease) [106]; however, is not considered appropriate as a first imaging modality in the setting of chronic, uncomplicated neck pain.