ACR Appropriateness Criteria® Cervical Pain or Cervical Radiculopathy: 2024 Update

Rami W. Eldaya, Washington University School of Medicine, Saint Louis, Missouri. Electronic address: reldaya@mdanderson.org.
Matthew S. Parsons, Panel Chair, Mallinckrodt Institute of Radiology, Saint Louis, Missouri.
Troy A. Hutchins, Panel Vice-Chair, University of Utah Health, Salt Lake City, Utah.
Ryan Avery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Commission on Nuclear Medicine and Molecular Imaging.
Judah Burns, Montefiore Medical Center, Bronx, New York.
Brent Griffith, Henry Ford Hospital, Detroit, Michigan.
Alvand Hassankhani, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Majid A. Khan, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Henry Ng, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine of the Case Western Reserve University, Cleveland, Ohio; American College of Physicians.
Noah M. Raizman, The Centers for Advanced Orthopaedics, George Washington University, Washington, District of Columbia, and Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; American Academy of Orthopaedic Surgeons.
Charles Reitman, Medical University of South Carolina, Charleston, South Carolina; North American Spine Society.
Vinil N. Shah, University of California, San Francisco, San Francisco, California.
Clint Sliker, University of Maryland School of Medicine, Baltimore, Maryland; Committee on Emergency Radiology, Commission on General, Small, Rural and Emergency Radiology.
Hesham Soliman, Northwell/Hofstra University Zucker School of Medicine, Manhasset, New York; American Association of Neurological Surgeons/Congress of Neurological Surgeons.
Vincent M. Timpone, Mayo Clinic Arizona, Phoenix, Arizona.
Christian A. Tomaszewski, UC San Diego Health, San Diego, California; American College of Emergency Physicians.
Noushin Yahyavi-Firouz-Abadi, University of Maryland School of Medicine, Baltimore, Maryland.
Bruno Policeni, Specialty Chair, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Document Type

Journal Article

Publication Date

5-1-2025

Journal

Journal of the American College of Radiology : JACR

Volume

22

Issue

5S

DOI

10.1016/j.jacr.2025.02.035

Keywords

AUC; Appropriateness Criteria; CT; MRI; appropriate use criteria; cervical spine acute pain; cervical spine chronic pain; cervical spine malignancy; cervical spine radiculopathy

Abstract

Cervical spine pain is one of the most common reasons for seeking medical care as it ranks in the top 5 causes of global years lost to disability. The economic burden of cervical pain is also significant. Imaging is at the center of diagnosis of cervical pain and its causes. However, different symptoms and potential causes of cervical pain require different initial imaging to maximize the benefit of diagnostic usefulness of imaging. In this document we address different cervical pain variants with detailed assessment of the strengths and weaknesses of different modalities for addressing each specific variant. 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 process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.

Department

Physician Assistant Studies

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