ACR Appropriateness Criteria ® Cervical Neck Pain or Cervical Radiculopathy

Expert Panel on Neurological Imaging:

Research output: Contribution to journalArticle

Abstract

Nontraumatic neck pain is a leading cause of disability, with nearly 50% of individuals experiencing ongoing or recurrent symptoms. Radiographs are appropriate as initial imaging for cervical or neck pain in the absence of “red flag” symptoms or if there are unchanging chronic symptoms; however, spondylotic changes are commonly identified and may result in both false-positive and false-negative findings. Noncontrast CT can be complementary to radiographs for evaluation of new or changing symptoms in the setting of prior cervical spine surgery or in the assessment of extent of ossification in the posterior longitudinal ligament. Noncontrast MRI is usually appropriate for assessment of new or increasing radiculopathy due to improved nerve root definition. MRI without and with contrast is usually appropriate in patients with new or increasing cervical or neck pain or radiculopathy in the setting of suspected infection or known malignancy. Imaging may be appropriate; however, it is not always indicated for evaluation of cervicogenic headache without neurologic deficit. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)S57-S76
JournalJournal of the American College of Radiology
Volume16
Issue number5
DOIs
StatePublished - May 1 2019

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Radiculopathy
Neck Pain
Post-Traumatic Headache
Ossification of Posterior Longitudinal Ligament
Guidelines
Expert Testimony
Neurologic Manifestations
Radiology
Spine
Therapeutics
Infection
Neoplasms

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

ACR Appropriateness Criteria ® Cervical Neck Pain or Cervical Radiculopathy . / Expert Panel on Neurological Imaging:.

In: Journal of the American College of Radiology, Vol. 16, No. 5, 01.05.2019, p. S57-S76.

Research output: Contribution to journalArticle

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