Magnetic Resonance Imaging Changes in the Size and Shape of the Oropharynx Following Acute Whiplash Injury

Abstract

Up to 50% of those who sustain a whiplash injury from a motor vehicle collision (MVC) transition from acute to chronic pain, 5 which results in a substantial personal and economic burden. 2 The variability of reported symptoms, including neck pain, complaints of dizziness, otological and ocular disturbances, headache, loss of concentration and short-term memory, anxiety, insomnia, and depression, 1,7,26,[30][31][32][33][34][35] can challenge even the most astute clinician. Further complicating the clinical picture is the presence of less-recognized symptoms, such as hoarseness, difficulty swallowing, 1,22 or voice changes, in chronic whiplash. 3 In general, such symptoms are not commonly associated with a whiplash injury, and the specific underlying causes for such changes are unknown. The advent and use of higherfield magnetic resonance imaging (MRI) systems in the research laboratory, however, have provided a foundation for quantifying physiologic processes (eg, muscle degeneration, [8][9][10][11][12] function, 4,13,25 and altered oropharyngeal morphometry 7 ) that could be associated with the T T STUDY DESIGN: Prospective longitudinal. T T OBJECTIVE:To quantify the temporal development of magnetic resonance imaging changes in oropharyngeal morphometry in subjects with varying levels of disability following a whiplash injury. T T BACKGROUND:A recent cross-sectional investigation has identified reductions in the size and shape of the oropharynx in subjects with chronic whiplash-related disability when compared to healthy controls. The temporal development of such changes and their relationship to persistent disability have yet to be investigated. T T METHODS:Forty-one subjects (30 women) with acute whiplash injury were included. Repeatedmeasures T1-weighted magnetic resonance imaging was used to measure and compare cross-sectional area (CSA) in square millimeters and shape ratio (SR) of the oropharynx at 4 weeks, 3 months, and 6 months postinjury. Subjects were classified at 6 months by their Neck Disability Index scores into the following categories: recovered (less than 8%), mild disability (10%-28%), and moderate/ severe disability (greater than 30%). The effects of time and group and the interaction effect of group by time on oropharynx morphometry (CSA, SR) were investigated using repeated-measures, linear, mixed-model analysis. Based on previous research findings, age, gender, and body mass index were entered into the analyses as covariates. Where significant main or interaction effects were detected, pairwise comparisons were performed to investigate specific differences in the dependent variable between groups and within groups over time. T T RESULTS:There was a significant interaction effect for group by time for both the CSA and SR values. Age significantly influenced SR (P = .024) and body mass index significantly influenced CSA (P = .001). There was no difference in CSA or SR across all groups at 4 weeks postinjury. However, at 6 months, CSA was significantly different between the recovered group an...

Longus colli tendinitis. A review of literature and case series

“…That is why a previous history of trauma to the head and neck (e.g. whiplash injury) should be considered [17]. A genetic predisposition has also been hypothesized [16].…”

“…Other investigations and interventions include CT brain to exclude subarachnoidal hemorrhage or other causes of headache and lumbar puncture to exclude meningitis [17, 25]. …”

Do findings identified on magnetic resonance imaging predict future neck pain? A systematic review

“…Agreement between the 2 independent reviewers was high (Kappa=0.67) with disagreements on 5 studies resolved through discussion and consensus with a third author (MH). There were eight studies that appeared to meet the inclusion criteria but did not present adequate data [25][26][27][28][29][30][31][32]. We contacted the authors and three provided the data required [30][31][32].…”

Magnetic resonance imaging atlas of the cervical spine musculature

“…The muscles of the cervical spine include both those that move the neck and the smaller muscles which control swallowing and phonation. Although previous research have indicated that the muscles for swallowing and phonation may also play a role in certain cervical spine pathologies such as whiplash and craniocervical injuries, current MR technology does not possess the resolution to accurately depict these small muscles (Anagnostara et al, ; Elliott et al, ; Elliott et al, ; Goulart et al, ). Therefore this article has focused on the 27 muscles that control cervical spine movements.…”