When should magnetic resonance imaging be considered with neck pain?

Review of recent evidence with translation to practice for the advanced practice nurse role is presented using a case study module for "Cervical Spine Magnetic Resonance Imaging in Alert, Neurologically Intact Trauma Patients With Persistent Midline Tenderness and Negative Computed Tomography Results." The study was designed to identify factors predictive of clinically significant spinal injury in neurologically intact trauma patients with persistent midline cervical tenderness, despite negative computed tomography and plain film findings. The authors reported a lack of guidelines to help emergency care providers identify which of these patients should undergo magnetic resonance imaging studies. The authors highlight the need to develop a clinical prediction rule, or clinical decision rule, to help providers caring for patients such as those with persistent neck pain. The implications and clinical relevance of these findings for advanced practice nurses are discussed highlighting best evidence.