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- The primary role of imaging is the identification of undiagnosed systemic disease.
- Spine imaging has a significant specificity fault.
- There is a high prevalence of asymptomatic degenerative changes.
- The significance depends on the concordance between imaging findings and the clinical presentation.
- Spine imaging may be insensitive to dynamic lesions.
- Ultimately spine imaging may fail to identify the pain source. For example ruptures of the capsule of a facet joint in the cervical spine from whiplash cannot be identified on imaging.