Studies evaluating the association between cervical plain film imaging pathology and facet pain
| Author, year | Patient population | Design | Results | Comments |
| Rudy et al 201584 | 322 pts with neck stiffness, shoulder pain, arm pain and/or headache attending chiropractic teaching clinics with cervical radiographs | Retrospective cross-sectional study | Symptoms of neck pain, headaches, referral of pain to the shoulder, and upper extremity radiculopathy did not correlate with cervical facet joint degeneration | Convenience sample with no asymptomatic comparison group. Small association between neck stiffness and facet hypertrophy |
| Van der Donk et al 199117 | 5440 volunteers 20–65 years of age enrolled in a national survey study stratified by presence of neck pain | Cross-sectional survey study | Osteoarthritis of the facet joints noted on cervical radiographs was not associated with neck pain | Mean age of participants was 46 years. Age was positively associated with neck pain |
| Gore et al 198783 | 205 pts with neck pain >10 years duration | Retrospective | Presence or severity of pain was not associated with the presence of degenerative changes including facet arthropathy, sagittal diameter of the spinal canal, or degree of cervical lordosis on initial or final cervical x-ray | 68 of 205 (33%) were involved in litigation. Mean age at onset of neck pain was 43 years; mean age at final evaluation was 58 years. |
| Heller et al 198382 | 653 case pts were referred for cervical spine x-ray. 365 control pts who were referred for barium studies received cervical spine x-rays | Retrospective case–control | No significant difference in the presence of cervical spondylosis between groups. There were no significant associations between neck, arm, or occipital pain, and neck stiffness with x-ray findings | Cervical spondylosis was positively correlated with age |