Fatty infiltrate in the cervical extensor muscles is not a feature of chronic, insidious-onset neck pain
From: Clinical Radiology 2008 Jun;63(6):681-687. Epub 2008 Jan 31
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. A sample of convenience of 23 women with persistent insidious-onset neck pain was recruited for the study. Magnetic resonance imaging was used to quantify fatty infiltration in the cervical extensor musculature. Quantitative Sensory Testing (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 and the General Health Questionnaire-28, respectively.
Measures were compared with those of a previous dataset of chronic whiplash patients. Using a classification tree, insidious-onset neck pain was clearly identified from whiplash, based on the presence of MRI fatty infiltrate in the cervical extensor musculature and altered temperature thresholds. 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 whiplash associated disorders. This novel finding may enable a better understanding of the underlying pathophysiological processes in patients with chronic whiplash.
