Fatty infiltrate in the cervical extensor muscles is not a feature of chronic, insidious onset neck pain
From: Clin Radiol. 2008 Jun;63(6):681-7. 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 (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 and the General Health Questionnaire-28 (GHQ-28), respectively. 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, based on the presence of MRI fatty infiltrate in the cervical extensor musculature (0/102 individuals) and altered temperature thresholds (cold; 3/102 individuals).
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.
