AIM: To investigate the presence of fatty infiltrate in the cervical extensor musculature in patients with insidious-onset neck pain to better understand the possible pathophysiology underlying such changes in chronic whiplash-associated disorders (WAD). MATERIALS AND METHODS: A sample of convenience of 23 women with persistent insidious-onset neck pain (mean age 29.2+/-6.9 years) was recruited for the study. Magnetic resonance imaging (MRI) was used to quantify fatty infiltration in the cervical extensor musculature. Quantitative Sensory Testing (QST; pressure and thermal pain thresholds) was performed as sensory features are present in chronic whiplash. Self-reported pain and disability, as well as psychological distress, were measured using the Neck Disability Index (NDI) and the General Health Questionnaire-28 (GHQ-28), respectively. RESULTS: Measures were compared with those of a previous dataset of chronic whiplash patients (n=79, mean age 29.7+/-7.8 years). Using a classification tree, insidious-onset neck pain was clearly identified from whiplash (p<0.001), based on the presence of MRI fatty infiltrate in the cervical extensor musculature (0/102 individuals) and altered temperature thresholds (cold; 3/102 individuals). CONCLUSION: Fatty infiltrates in the cervical extensor musculature and widespread hyperalgesia were not features of the insidious-onset neck pain group in this study; whereas these features have been identified in patients with chronic WAD. This novel finding may enable a better understanding of the underlying pathophysiological processes in patients with chronic whiplash.
AIM: To investigate the presence of fatty infiltrate in the cervical extensor musculature in patients with insidious-onset neck pain to better understand the possible pathophysiology underlying such changes in chronic whiplash-associated disorders (WAD). MATERIALS AND METHODS: A sample of convenience of 23 women with persistent insidious-onset neck pain (mean age 29.2+/-6.9 years) was recruited for the study. Magnetic resonance imaging (MRI) was used to quantify fatty infiltration in the cervical extensor musculature. Quantitative Sensory Testing (QST; pressure and thermal pain thresholds) was performed as sensory features are present in chronic whiplash. Self-reported pain and disability, as well as psychological distress, were measured using the Neck Disability Index (NDI) and the General Health Questionnaire-28 (GHQ-28), respectively. RESULTS: Measures were compared with those of a previous dataset of chronic whiplash patients (n=79, mean age 29.7+/-7.8 years). Using a classification tree, insidious-onset neck pain was clearly identified from whiplash (p<0.001), based on the presence of MRI fatty infiltrate in the cervical extensor musculature (0/102 individuals) and altered temperature thresholds (cold; 3/102 individuals). CONCLUSION: Fatty infiltrates in the cervical extensor musculature and widespread hyperalgesia were not features of the insidious-onset neck pain group in this study; whereas these features have been identified in patients with chronic WAD. This novel finding may enable a better understanding of the underlying pathophysiological processes in patients with chronic whiplash.
Authors: Andrew C Smith; Todd B Parrish; Mark A Hoggarth; Jacob G McPherson; Vicki M Tysseling; Marie Wasielewski; Hyosub E Kim; T George Hornby; James M Elliott Journal: Spinal Cord Ser Cases Date: 2015-10-08
Authors: James M Elliott; D Mark Courtney; Alfred Rademaker; Daniel Pinto; Michele M Sterling; Todd B Parrish Journal: Spine (Phila Pa 1976) Date: 2015-06-15 Impact factor: 3.468
Authors: James M Elliott; Sudarshan Dayanidhi; Charles Hazle; Mark A Hoggarth; Jacob McPherson; Cheryl L Sparks; Kenneth A Weber Journal: J Orthop Sports Phys Ther Date: 2016-10 Impact factor: 4.751