Whiplash injuries: Is there a role for imaging?

Whiplash describes the manner in which a head is moved suddenly to produce a sprain in the neck and typically occurs after rear-end automobile collisions. It is one of the most common mechanisms of injury to the cervical spine. Although considered by some to be a form of compensation neurosis, evidence suggests that whiplash injuries are real and that they are a potential cause of significant impairment. Symptoms of cervical whiplash injury include neck pain and stiffness, interscapular pain, arm pain and/or occipital headache, and many whiplash patients have persistent complaints. Cervical roentgenography and conventional or computed tomography (CT) may show dislocations, subluxations and fractures in severely traumatized patients, but often fail to determine or visualize the cause for a whiplash syndrome. Magnetic resonance imaging (MRI), however, is able to assess different types of soft-tissue lesions related to whiplash injuries. Dynamic imaging may show functional disturbances. More widespread use of flexion/extension views, high-resolution static MRI and especially dynamic MRI should improve the correlation between imaging findings and patients' complaints.