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Imaging Appropriateness for Neck Pain.

Justin E Costello1, Lubdha M Shah2, Miriam E Peckham2

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Imaging for neck pain is costly. This study found clinicians use guidelines but need clearer protocols for cervical spine imaging, leading to a new decision-making algorithm.

Keywords:
Cervical disc degenerationcervical spine traumaimaging appropriatenessneck pain

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Area of Science:

  • Radiology
  • Healthcare Management
  • Clinical Decision Support

Background:

  • Neck pain imaging represents a substantial healthcare expense.
  • Current practices heavily rely on radiologic studies.
  • Existing consensus guidelines aim to optimize imaging selection for neck pain.

Purpose of the Study:

  • To assess adherence to imaging guidelines for neck pain.
  • To identify discrepancies between guidelines and actual practice.
  • To develop an algorithm for appropriate neck pain imaging.

Main Methods:

  • Analysis of imaging examinations for neck pain at a university medical center over one year.
  • Review of clinical presentation and referral patterns.
  • Literature review to inform algorithm development.

Main Results:

  • Clinicians appear to utilize consensus imaging guidelines.
  • Uncertainty persists regarding appropriate "when not to image" scenarios for the cervical spine.
  • Trends suggest a need for refined imaging protocols.

Conclusions:

  • Development of a novel algorithm to guide appropriate imaging utilization for neck pain.
  • The algorithm integrates clinical presentation, referral patterns, and literature review.
  • Aims to promote judicious use of radiologic studies in managing neck pain.