Cervical Facet Syndrome Workup

Updated: Oct 10, 2023
  • Author: Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM; Chief Editor: Craig C Young, MD  more...
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Workup

Laboratory Studies

Laboratory studies are generally not indicated for the diagnosis of cervical facet joint syndrome.

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Imaging Studies

Radiographs in the neutral, flexed, and extended positions, should be obtained and the degree of movement measured in patients suspected with cervical facet syndrome.

Horizontal movement of one vertebral body on the next should not exceed 3.5 mm, and the angular displacement of one body on the next should be less than 11°. These criteria may not always be applicable in the younger athlete, in whom ligamentous laxity may accentuate these measurements. More specifically, the normal translation of the OA joint in the sagittal plane is insignificant.

The C1-C2 translation is normally between 2 and 3 mm, although some authors suggest 2.5 mm for adults and 4.5 mm for children as the upper limit of normal motion. For the lower cervical segments (C2-T1), normal translation in the sagittal plane is between 2.7 mm and 3.5 mm. Ligamentous injuries, however, seem to be more common in the younger athlete (age < 11 y) and located in the cephalic portion of the cervical spine; osseous and more caudally located injuries are seen in the older athlete.

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