Lack of Objective Measurement in the Initial Screening and Follow-Up of Patients Who Report Whiplash Injury—Is Elastography of the Trapezius Muscle an Answer?

• Published in: Journal of clinical medicine Vol. 11; no. 13; p. 3851
• Main Authors: Aljinović, Jure, Barun, Blaž, Benzon, Benjamin, Poljičanin, Ana, Vlak, Tonko
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 02.07.2022; MDPI
• Subjects: Age; Clinical medicine; Gender; Hypotheses; Injuries; Muscle pain; Neck; Patients; Radiation; Range of motion; Review; Ultrasonic imaging
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11133851

Background: Painfully decreased cervical range of motion accompanied by muscle spasm is a common presentation of whiplash injury of the neck. Stiffness of the cervical muscles can be assessed by ultrasound shear wave elastography (SWE), expressed in kilopascals (kPa). The hypothesis: SWE of the trapezius muscle is an objective measurement suitable for the initial screening and follow-up of patients who report whiplash injury. Methods and results: A total of 99 patients after whiplash injury were compared to 75 control participants. Mean trapezius stiffness was 82.24 ± 21.11 vs. 57.47 ± 13.82 for whiplash patients and controls, respectively. The cut-off value of SWE of 75.8 kPa showed 77% accuracy in correctly assigning patients to the whiplash or control group. To evaluate whether SWE can be used as a follow-up method of recovery after a whiplash injury, initial and endpoint SWE (after six months, n = 24) was carried out. Patients reporting no recovery showed similar SWE values as completely recovered patients. This finding refutes the second part of our hypothesis. Conclusions: SWE is a method that can be used for the initial screening of patients with whiplash injury, but we are still searching for an objective measurement that can be used in the follow-up of recovery.