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Localized cervical pain: advantages and limits of ultrasound evaluation

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Abstract

Purpose

Cervical pain is very frequent in the general population. In clinical practice, plain X-ray and, in selected cases, computed tomography or magnetic resonance imaging, are performed. However, the feasibility and utility of ultrasound examination have been poorly investigated. Aim of the present study was to evaluate whether ultrasound could be useful in the diagnosis of localized cervical pain.

Methods

Subjects suffering from posterior cervical pain without irradiation to surrounding tissues were enrolled. After clinical and functional evaluation (demographic and anthropometric data, VAS at rest and during neck movements, symptoms duration, and characteristics of pain onset [atraumatic or traumatic]), an ultrasound exam of the cervical spine was performed according to standard protocols.

Results

The anatomic structures of the neck district were visualized in 124/127 enrolled patients and pathological features were observed in 58. Significant ultrasound differences were registered between the patients with traumatic and atraumatic onset of neck pain. In the first group, articular effusion, capsular bulging, disalignment and avulsion of the articular apex were observed, whereas in the latter cortical irregularities, osteophytosis, and articular ankylosis were prevalent.

Conclusions

Ultrasound examination can be used as diagnostic tool in the evaluation of selected patients suffering from localized cervical pain, particularly in cases of pain due to traumatic injuries.

Sommario

Scopo del lavoro

Il dolore del rachide cervicale è molto diffuso, specialmente nella popolazione femminile di mezza età. Diversi esami strumentali vengono comunemente utilizzati, fra i quali la radiografia convezionale e, in casi selezionati, la Tomografia Assiale Computerizzata e la Risonanza Magnetica. Tuttavia, l’utilizzo dell’esame ultrasonografico è stato raramente riportato in letteratura. Scopo del presente studio èquello di valutare l’utilità dell’ecografia nella diagnosi del dolore localizzato al rachide cervicale.

Metodi

Sono stati selezionati pazienti affetti da dolore posteriore del rachide cervicale senza irradiazione ai tessuti circostanti. Dopo una valutazione clinica e funzionale (dati demografici ed antropometrici, dolore a riposo e durante i movimenti del collo misurato su scala VAS, durata dei sintomi e caratteristiche di insorgenza del dolore [traumatica, a-traumatica]), è stato eseguito un esame ecografico del rachide cervicale secondo protocolli standard.

Risultati

Le normali strutture del collo (ossa, articolazioni, muscoli, legamenti) sono state visualizzate in 124/127 soggetti ed in 58 di essi sono state riscontrate alterazione ecografiche di significato patologico. Fra i pazienti con genesi traumatica e atraumatica l’analisi statistica ha evidenziato differenze significative in termini di età, BMI, durata dei sintomi ed intensità del dolore. Nei soggetti con danno traumatico l’esame ecografico ha dimostrato effusione articolare e bulging capsulare, disallineamento dei capi articolari ed avulsione dell’apice articolare; nei pazienti con danno a-traumatico sono state invece osservate alterazioni degenerative artrosiche (irregolarità corticale, osteofitosi, anchilosi).

Conclusioni

L’esame ecografico può essere utilizzato come indagine di primo livello in alcuni pazienti affetti da interessamento del rachide cervicale, soprattutto nel dolore post-traumatico.

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Authors and Affiliations

  1. Musculoskeletal ultrasound School, Italian Society for Ultrasound in Medicine and Biology (SIUMB), Bologna, Italy

    Stefano Galletti & Riccardo Galletti

  2. Department of Medicine and Sciences of Aging, University “G. d’ Annunzio”, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti Scalo, CH, Italy

    Cosima Schiavone, Vincenzo Salini & Michele Abate

Authors
  1. Stefano Galletti
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  2. Riccardo Galletti
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  3. Cosima Schiavone
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  4. Vincenzo Salini
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  5. Michele Abate
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Correspondence to Michele Abate.

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Conflict of interest

The authors declare no potential conflicts of interests with respect to the authorship and/or publication of this article. They do not have a financial relationship with the organization that sponsored the research. The authors have full control of all primary data and agree to allow the journal to review their data if requested.

Ethical approval

The experiments comply with the current laws of the country in which they were performed. All procedures performed in study involving human participants were in accordance with the ethical standards of the institutional and/or national committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed written consent was obtained from all the subjects.

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This work has not been published previously, it is not under consideration for publication elsewhere, its publication is approved by all authors and by the responsible authorities where the work was carried out. All authors participated in the work and agree to the submission of the paper to the journal.

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Galletti, S., Galletti, R., Schiavone, C. et al. Localized cervical pain: advantages and limits of ultrasound evaluation. J Ultrasound 19, 257–263 (2016). https://doi.org/10.1007/s40477-016-0207-4

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  • DOI: https://doi.org/10.1007/s40477-016-0207-4

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