Fatty infiltrate in the cervical extensor muscles is not a feature of chronic, insidious-onset neck pain.

Abstract:

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.

journal_name

Clin Radiol

journal_title

Clinical radiology

authors

Elliott J,Sterling M,Noteboom JT,Darnell R,Galloway G,Jull G

doi

10.1016/j.crad.2007.11.011

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

681-7

issue

6

eissn

0009-9260

issn

1365-229X

pii

S0009-9260(07)00516-8

journal_volume

63

pub_type

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