PDF herunterladen
Semin Musculoskelet Radiol 2023; 27(05): 512-521
DOI: 10.1055/s-0043-1772170
Review Article

Imaging in Whiplash-Associated Disorders

Joris Schollaert 
1   Department of Medical and Molecular Imaging, VITAZ, Sint-Niklaas, Belgium
2   Department of Radiology, University Hospital of Antwerp, Antwerp, Belgium
,
Johan W.M. Van Goethem 
1   Department of Medical and Molecular Imaging, VITAZ, Sint-Niklaas, Belgium
2   Department of Radiology, University Hospital of Antwerp, Antwerp, Belgium
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
    Lizenzen und Reprints

Abstract

“Whiplash,” a term describing the severe acceleration and deceleration forces applied to the head, craniocervical junction (CCJ), and cervical spine during trauma, is one of the most frequent mechanisms of injury to the CCJ. The CCJ is a complex region at the transition of the cranium and the cervical spine, essential for maintaining craniocervical stability. In whiplash injuries, the CCJ may be compromised due to underlying ligamentous or, less frequently, osseous, intravertebral disk and/or muscular lesions. Imaging is crucial in detecting acute lesions but may also play a role in the follow-up of chronic pathology because soft tissue lesions and progressive disk pathology could contribute to a whiplash-associated disorder.

Keywords

cervical spine - craniocervical junction - magnetic resonance imaging - computed tomography - whiplash injuries


Publikationsverlauf

Artikel online veröffentlicht:
10. Oktober 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Spitzer WO, Skovron ML, Salmi LR. et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining “whiplash” and its management. Spine 1995; 20 (8, Suppl): 1S-73S
    PubMedSuche in Google Scholar
  • 2 Dvorak J, Panjabi M, Gerber M, Wichmann W. CT-functional diagnostics of the rotatory instability of upper cervical spine. 1. An experimental study on cadavers. Spine 1987; 12 (03) 197-205
    CrossrefPubMedSuche in Google Scholar
  • 3 Kumagai G, Wada K, Tanaka S. et al. Prevalence of whiplash injury and its association with quality of life in local residents in Japan: a cross sectional study. J Orthop Sci 2022; 27 (01) 108-114
    CrossrefPubMedSuche in Google Scholar
  • 4 Naqui SZ, Lovell SJ, Lovell ME. Underestimation of severity of previous whiplash injuries. Ann R Coll Surg Engl 2008; 90 (01) 51-53
    CrossrefPubMedSuche in Google Scholar
  • 5 Erbulut DU. Biomechanics of neck injuries resulting from rear-end vehicle collisions. Turk Neurosurg 2014; 24 (04) 466-470
    PubMedSuche in Google Scholar
  • 6 Kasch H, Kongsted A, Qerama E, Bach FW, Bendix T, Jensen TS. A new stratified risk assessment tool for whiplash injuries developed from a prospective observational study. BMJ Open 2013; 3 (01) e002050
    CrossrefPubMedSuche in Google Scholar
  • 7 Kasch H, Stengaard-Pedersen K, Arendt-Nielsen L, Staehelin Jensen T. Headache, neck pain, and neck mobility after acute whiplash injury: a prospective study. Spine 2001; 26 (11) 1246-1251
    CrossrefPubMedSuche in Google Scholar
  • 8 Vincent MB. Cervicogenic headache: a review comparison with migraine, tension-type headache, and whiplash. Curr Pain Headache Rep 2010; 14 (03) 238-243
    CrossrefPubMedSuche in Google Scholar
  • 9 Chung YS, Han DH. Vertebrobasilar dissection: a possible role of whiplash injury in its pathogenesis. Neurol Res 2002; 24 (02) 129-138
    CrossrefPubMedSuche in Google Scholar
  • 10 Brown S. Effect of whiplash injury on accommodation. Clin Exp Ophthalmol 2003; 31 (05) 424-429
    CrossrefPubMedSuche in Google Scholar
  • 11 Al-Khazali HM, Ashina H, Iljazi A. et al. Psychiatric sequelae following whiplash injury: a systematic review. Front Psychiatry 2022; 13: 814079
    CrossrefPubMedSuche in Google Scholar
  • 12 Riascos R, Bonfante E, Cotes C, Guirguis M, Hakimelahi R, West C. Imaging of atlanto-occipital and atlantoaxial traumatic injuries: what the radiologist needs to know. Radiographics 2015; 35 (07) 2121-2134
    CrossrefPubMedSuche in Google Scholar
  • 13 Mohamed MA, Majeske KD, Sachwani-Daswani G. et al. Impact of MRI on changing management of the cervical spine in blunt trauma patients with a ‘negative’ CT scan. Trauma Surg Acute Care Open 2016; 1 (01) e000016
    CrossrefPubMedSuche in Google Scholar
  • 14 Van Goethem JWM, Maes M, Özsarlak O, van den Hauwe L, Parizel PM. Imaging in spinal trauma. Eur Radiol 2005; 15 (03) 582-590
    CrossrefPubMedSuche in Google Scholar
  • 15 Van Geothem JW, Biltjes IGGM, van den Hauwe L, Parizel PM, De Schepper AMA. Whiplash injuries: is there a role for imaging?. Eur J Radiol 1996; 22 (01) 30-37
    CrossrefPubMedSuche in Google Scholar
  • 16 Baumert B, Wörtler K, Steffinger D, Schmidt GP, Reiser MF, Baur-Melnyk A. Assessment of the internal craniocervical ligaments with a new magnetic resonance imaging sequence: three-dimensional turbo spin echo with variable flip-angle distribution (SPACE). Magn Reson Imaging 2009; 27 (07) 954-960
    CrossrefPubMedSuche in Google Scholar
  • 17 Peters B, Parizel PM, Van Goethem JW. Age-related changes to the craniocervical ligaments in asymptomatic subjects: a prospective MR study. Eur Spine J 2020; 29 (05) 1029-1035
    CrossrefPubMedSuche in Google Scholar
  • 18 Dickman CA, Mamourian A, Sonntag VK, Drayer BP. Magnetic resonance imaging of the transverse atlantal ligament for the evaluation of atlantoaxial instability. J Neurosurg 1991; 75 (02) 221-227
    CrossrefPubMedSuche in Google Scholar
  • 19 Tubbs RS, Hallock JD, Radcliff V. et al. Ligaments of the craniocervical junction. J Neurosurg Spine 2011; 14 (06) 697-709
    CrossrefPubMedSuche in Google Scholar
  • 20 Fielding JW, Cochran Gv, Lawsing III JF, Hohl M. Tears of the transverse ligament of the atlas. A clinical and biomechanical study. J Bone Joint Surg Am 1974; 56 (08) 1683-1691
    CrossrefPubMedSuche in Google Scholar
  • 21 Pfirrmann CW, Binkert CA, Zanetti M, Boos N, Hodler J. MR morphology of alar ligaments and occipitoatlantoaxial joints: study in 50 asymptomatic subjects. Radiology 2001; 218 (01) 133-137
    CrossrefPubMedSuche in Google Scholar
  • 22 Anderson PA, Montesano PX. Morphology and treatment of occipital condyle fractures. Spine 1988; 13 (07) 731-736
    CrossrefPubMedSuche in Google Scholar
  • 23 Tubbs RS, Kelly DR, Humphrey ER. et al. The tectorial membrane: anatomical, biomechanical, and histological analysis. Clin Anat 2007; 20 (04) 382-386
    CrossrefPubMedSuche in Google Scholar
  • 24 Lang J. Clinical Anatomy of the Head: Neurocranium, Orbit, Craniocervical Regions. Berlin, Germany: Springer; 1983
    CrossrefSuche in Google Scholar
  • 25 Meoded A, Singhi S, Poretti A, Eran A, Tekes A, Huisman TA. Tectorial membrane injury: frequently overlooked in pediatric traumatic head injury. AJNR Am J Neuroradiol 2011; 32 (10) 1806-1811
    CrossrefPubMedSuche in Google Scholar
  • 26 Fiester P, Soule E, Natter P, Rao D. Tectorial membrane injury in adult and pediatric trauma patients: a retrospective review and proposed classification scheme. Emerg Radiol 2019; 26 (06) 615-622
    CrossrefPubMedSuche in Google Scholar
  • 27 Fiester P, Rao D, Soule E, Orallo P, Rahmathulla G. Anatomic, functional, and radiographic review of the ligaments of the craniocervical junction. J Craniovertebr Junction Spine 2021; 12 (01) 4-9
    CrossrefPubMedSuche in Google Scholar
  • 28 Panjabi MM, Oxland TR, Parks EH. Quantitative anatomy of cervical spine ligaments. Part I. Upper cervical spine. J Spinal Disord 1991; 4 (03) 270-276
    PubMedSuche in Google Scholar
  • 29 Tubbs RS, Grabb P, Spooner A, Wilson W, Oakes WJ. The apical ligament: anatomy and functional significance. J Neurosurg 2000; 92 (2, Suppl): 197-200
    PubMedSuche in Google Scholar
  • 30 Tubbs RS, Dixon J, Loukas M, Shoja MM, Cohen-Gadol AA. Ligament of Barkow of the craniocervical junction: its anatomy and potential clinical and functional significance. J Neurosurg Spine 2010; 12 (06) 619-622
    CrossrefPubMedSuche in Google Scholar
  • 31 Pettersson K, Hildingsson C, Toolanen G, Fagerlund M, Björnebrink J. Disc pathology after whiplash injury. A prospective magnetic resonance imaging and clinical investigation. Spine 1997; 22 (03) 283-287 , discussion 288
    CrossrefPubMedSuche in Google Scholar
  • 32 Barnsley L, Lord S, Bogduk N. Whiplash injury. Pain 1994; 58 (03) 283-307
    CrossrefPubMedSuche in Google Scholar
  • 33 Ulbrich EJ, Añon J, Hodler J. et al. Does normalized signal intensity of cervical discs on T2 weighted MRI images change in whiplash patients?. Injury 2014; 45 (04) 784-791
    CrossrefPubMedSuche in Google Scholar
  • 34 Matsumoto M, Ichihara D, Okada E. et al. Modic changes of the cervical spine in patients with whiplash injury: a prospective 11-year follow-up study. Injury 2013; 44 (06) 819-824
    CrossrefPubMedSuche in Google Scholar
  • 35 Karlsson A, Leinhard OD, Åslund U. et al. An investigation of fat infiltration of the multifidus muscle in patients with severe neck symptoms associated with chronic whiplash-associated disorder. J Orthop Sports Phys Ther 2016; 46 (10) 886-893
    CrossrefPubMedSuche in Google Scholar
  • 36 Elliott JM, Smith AC, Hoggarth MA. et al. Muscle fat infiltration following whiplash: a computed tomography and magnetic resonance imaging comparison. PLoS One 2020; 15 (06) e0234061
    CrossrefPubMedSuche in Google Scholar
  • 37 Elliott JM, Courtney DM, Rademaker A, Pinto D, Sterling MM, Parrish TB. The rapid and progressive degeneration of the cervical multifidus in whiplash: an MRI study of fatty infiltration. Spine 2015; 40 (12) E694-E700
    CrossrefPubMedSuche in Google Scholar
  • 38 Elliott J, Pedler A, Kenardy J, Galloway G, Jull G, Sterling M. The temporal development of fatty infiltrates in the neck muscles following whiplash injury: an association with pain and posttraumatic stress. PLoS One 2011; 6 (06) e21194
    CrossrefPubMedSuche in Google Scholar
  • 39 Takhtani D, Scortegagna E, Cataltepe O, Dundamadappa S. MRI findings of injury to the longus colli muscle in patients with neck trauma. AJR Am J Roentgenol 2016; 207 (02) 401-405
    CrossrefPubMedSuche in Google Scholar
  • 40 Ronnen HR, de Korte PJ, Brink PR, van der Bijl HJ, Tonino AJ, Franke CL. Acute whiplash injury: is there a role for MR imaging? A prospective study of 100 patients. Radiology 1996; 201 (01) 93-96
    CrossrefPubMedSuche in Google Scholar
  • 41 Hacking C, Deng F. Anderson and Montesano classification of occipital condyle fractures. Available at: Radiopaedia.org. Accessed on August 7, 2023. https://doi.org/10.53347/rID-87202
    CrossrefPubMed
  • 42 Mueller FJ, Fuechtmeier B, Kinner B. et al. Occipital condyle fractures. Prospective follow-up of 31 cases within 5 years at a level 1 trauma centre. Eur Spine J 2012; 21 (02) 289-294
    CrossrefPubMedSuche in Google Scholar
  • 43 Gehweiler JA, Duff DE, Martinez S. et al. Fractures of the atlas vertebra. Skeletal Radiol 1976; (01) 97-102 https://doi.org/10.1007/BF00347414
    CrossrefPubMedSuche in Google Scholar
  • 44 Hacking C, Zinaye A, Bell D. Gehweiler classification of atlas fractures. Available at: Radiopaedia.org. Accessed on August 7, 2023. https://doi.org/10.53347/rID-86947
    CrossrefPubMed
  • 45 Fiester P, Soule E, Rao D. et al. Appropriateness of cervical magnetic resonance imaging in the evaluation and management of C1 Jefferson fractures. World Neurosurg 2022; 167: e137-e145
    CrossrefPubMedSuche in Google Scholar
  • 46 Anderson LD, D'Alonzo RT. Fractures of the odontoid process of the axis. J Bone Joint Surg Am 1974; 56 (08) 1663-1674
    CrossrefPubMedSuche in Google Scholar
  • 47 Hacking C, Weerakkody Y, Smith D. et al. Anderson and D'Alonzo classification of odontoid process fracture. Available at: Radiopaedia.org. Accessed on August 7, 2023. https://doi.org/10.53347/rID-41604
    CrossrefPubMed
  • 48 Grauer JN, Shafi B, Hilibrand AS. et al. Proposal of a modified, treatment-oriented classification of odontoid fractures. Spine J 2005; 5 (02) 123-129
    CrossrefPubMedSuche in Google Scholar
  • 49 Krakenes J, Kaale BR. Magnetic resonance imaging assessment of craniovertebral ligaments and membranes after whiplash trauma. Spine 2006; 31 (24) 2820-2826
    CrossrefPubMedSuche in Google Scholar
  • 50 Chen J, Wang W, Han G, Han X, Li X, Zhan Y. MR investigation in evaluation of chronic whiplash alar ligament injury in elderly patients. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2015; 40 (01) 67-71
    PubMedSuche in Google Scholar
  • 51 Ulbrich EJ, Eigenheer S, Boesch C. et al. Alterations of the transverse ligament: an MRI study comparing patients with acute whiplash and matched control subjects. AJR Am J Roentgenol 2011; 197 (04) 961-967
    CrossrefPubMedSuche in Google Scholar
  • 52 Uhrenholt L, Brix L, Wichmann TO, Pedersen M, Ringgaard S, Jensen TS. Advanced magnetic resonance imaging of chronic whiplash patients: a clinical practice-based feasibility study. Chiropr Man Therap 2022; 30 (01) 2
    CrossrefPubMedSuche in Google Scholar
  • 53 Dullerud R, Gjertsen O, Server A. Magnetic resonance imaging of ligaments and membranes in the craniocervical junction in whiplash-associated injury and in healthy control subjects. Acta Radiol 2010; 51 (02) 207-212
    CrossrefPubMedSuche in Google Scholar
  • 54 Myran R, Kvistad KA, Nygaard OP, Andresen H, Folvik M, Zwart JA. Magnetic resonance imaging assessment of the alar ligaments in whiplash injuries: a case-control study. Spine 2008; 33 (18) 2012-2016
    CrossrefPubMedSuche in Google Scholar