Original Article

European Spine Journal

, Volume 18, Issue 9, pp 1371-1378

First online:

The clinical presentation of chronic whiplash and the relationship to findings of MRI fatty infiltrates in the cervical extensor musculature: a preliminary investigation

  • James ElliottAffiliated withSchool of Health and Rehabilitation Sciences, Division of Physiotherapy, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, The University of QueenslandCentre for Magnetic Resonance, The University of QueenslandCentre of National Research on Disability and Rehabilitation Medicine, The University of QueenslandDepartment of Physical Therapy, Rueckert-Hartman School for Health Professions, Regis University Email author 
  • , Michele SterlingAffiliated withSchool of Health and Rehabilitation Sciences, Division of Physiotherapy, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, The University of QueenslandCentre of National Research on Disability and Rehabilitation Medicine, The University of Queensland
  • , Jon Timothy NoteboomAffiliated withDepartment of Physical Therapy, Rueckert-Hartman School for Health Professions, Regis University
  • , Julia TreleavenAffiliated withSchool of Health and Rehabilitation Sciences, Division of Physiotherapy, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, The University of Queensland
  • , Graham GallowayAffiliated withCentre for Magnetic Resonance, The University of Queensland
  • , Gwendolen JullAffiliated withSchool of Health and Rehabilitation Sciences, Division of Physiotherapy, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, The University of Queensland

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Abstract

The objective was to determine whether any measurable changes in sensory responses, kinesthetic sense, cervical motion, and psychological features were related to established fatty infiltration values in the cervical extensor musculature in subjects with persistent whiplash. It is unknown if fatty infiltrate is related to any signs or symptoms. Data on motor function, Quantitative Sensory Testing, psychological and general well-being, and pain and disability were collected from 79 female subjects with chronic whiplash. Total fat values were created for all subjects by averaging the muscle fat indices by muscle, level, and side from our MRI dataset of all the cervical extensor muscles. Results of this study indicate the presence of altered physical, kinesthetic, sensory, and psychological features in this cohort of patients with chronic whiplash. Combined factors of sensory, physical, kinesthetic, and psychological features all contributed to a small extent in explaining the varying levels of fatty infiltrate, with cold pain thresholds having the most influence (r 2 = 0.28; P = 0.02). Identifying and relating quantifiable muscular alterations to clinical measures in the chronic state, underpin some clinical hypotheses for possible pathophysiological processes in this group with a chronic and recalcitrant whiplash disorder. Future research investigations aimed at accurate identification, sub-classification, prediction, and management of patients with acute and chronic whiplash is warranted and underway.

Keywords

MRI Whiplash Pain Cervical