INTRODUCTION Diagnostic imaging for the majority of people with nonspecific regional musculoskeletal complaints has limited value. First, degenerative findings are common in asymptomatic people and increase with age. For example, a systematic review including 33 studies (n = 3,110) found vertebral disc degeneration is present in approximately 37% and 96% of asymptomatic 20- and 80-year-olds, respectively (1).