MRI Cervical Spine [ED/INPATIENT/OUTPATIENT]
MRIVaries
EDInpatientOutpatient
ED/Inpatient — post-CT MRI indications
After CT, if neurological abnormality attributable to spinal cord injury → MRI
- After CT, neurological abnormality attributable to spinal cord injury → MRINICE NG41 Rec 1.5.6
- MRI more sensitive for: cord oedema, cord haemorrhage, ligamentous injury, SCIWORA
Outpatient indications
— ANY of the following
- Cervical myelopathy (positive Babinski, Hoffmann's, Lhermitte's signs; gait disturbance; UMN signs)
- Progressive radiculopathy unresponsive to ≥6 weeks conservative management
- RA with cervical myelopathy symptoms — urgent MRINICE NG100 Rec 1.10.5
- Neck pain alone without neurological features — rarely changes management, justify carefully
Notes
Information
MRI more sensitive than CT for cord injury, ligamentous injury, and SCIWORA
Local preference
MRI preferred over CT for cord assessment
Warning
Neck pain alone without neurological features rarely changes management
Pregnancy
MRI cervical spine can be performed in pregnancy. No gadolinium unless essential.
Modality Preference
MRI preferred. Superior for cord, ligamentous, and soft tissue assessment
Source: NICE NG41; RCR iRefer
Change Log
v2.02026-03-08New protocol — MRI cervical spine indications for ED, inpatient, and outpatient settings