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Can measuring passive neck muscle stiffness in whiplash injury patients help detect false whiplash claims?

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Summary

Background

Whiplash injury of the cervical spine is the most common injury after a car accident and in 25% of patients it progresses into chronic neck pain.

Aim of the study

To investigate the difference in neck muscle stiffness using shear wave ultrasound elastography between subjects who suffered an uncomplicated whiplash injury and a control group. Possible recognition of patients who insist on physical therapy in order to support their false whiplash injury claims.

Methods

This study included 75 whiplash injury patients and 75 control subjects. Trapezius, splenius capitis and sternocleidomastoid muscles were examined by ultrasound shear wave elastography.

Results

Increased muscle stiffness was noticed in trapezius muscle bilaterally in the whiplash group when compared to the control group (p < 0.001; right 57.47 ± 13.82 kPa vs. 87.84 ± 23.23 kPa; left 54.4 ± 12.68 kPa vs. 87.21 ± 26.47 kPa). Muscle stiffness in splenius capitis and sternocleidomastoid muscles was not suitable for analysis because of asymmetrical data distribution. Patients with less than 76 kPa of muscle stiffness in trapezius muscle are unlikely to belong in whiplash injury group (sensitivity 90% for right and 97% for left trapezius muscle, specificity 72% and 73%, respectively).

Conclusion

Patients measuring below 76 kPa of muscle stiffness in the trapezius muscle might have no whiplash injury. Further follow-up of the patients measuring higher than cut-off value might be beneficial for detecting patients with prolonged neck muscle spasm that can lead to chronic cervical pain syndrome.

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Acknowledgements

The authors would like to acknowledge Professor Goran Kardum, PhD, for statistical analysis, Ana Krnić, MD and Benjamin Benzon, MD, PhD for their help with the study design, and Renato Igrec MD for drawing the ultrasound probe positioning.

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Authors and Affiliations

  1. Institute of Physical and Rehabilitation Medicine with Rheumatology, University Hospital of Split, Šoltanska 1, 21000, Split, Croatia

    Jure Aljinović, Ana Poljičanin, Sandra Kuzmičić & Tonko Vlak

  2. Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia

    Igor Barišić

  3. Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Split, Croatia

    Katarina Vukojević

  4. Clinical Department of Pathology, Forensic Medicine and Cytology, University Hospital of Split, Split, Croatia

    Dijana Gugić Bokun

  5. Department of Health Studies, University of Split, Split, Croatia

    Jure Aljinović & Ana Poljičanin

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  1. Jure Aljinović
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  2. Igor Barišić
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  3. Ana Poljičanin
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  4. Sandra Kuzmičić
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  5. Katarina Vukojević
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  6. Dijana Gugić Bokun
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  7. Tonko Vlak
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Correspondence to Jure Aljinović.

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Conflict of interest

J. Aljinović, I. Barišić, A. Poljičanin, S. Kuzmičić, K. Vukojević, D. Gugić Bokun, and T. Vlak declare that they have no competing interests.

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J. Aljinović and I. Barišić equally contributed to this paper as first authors.

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Aljinović, J., Barišić, I., Poljičanin, A. et al. Can measuring passive neck muscle stiffness in whiplash injury patients help detect false whiplash claims?. Wien Klin Wochenschr 132, 506–514 (2020). https://doi.org/10.1007/s00508-020-01631-y

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  • DOI: https://doi.org/10.1007/s00508-020-01631-y

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