Includes whiplash associated disorders. It is not uncommon for patients to report persistent neck symptoms after sustaining blunt cervical trauma, even in light of negative initial cervical spine imaging. Neck pain and stiffness, mechanical symptoms (ie, decreased range of motion, point tenderness), and neurologic symptoms frequently persist for months after sustaining cervical trauma and constitute a spectrum of cervical spine injuries commonly referred to as whiplash associated disorders (WAD) [84]. Many different structures have been hypothesized as the source of pain in WAD, most notably the paraspinal muscles, facets, discs, and craniocervical ligaments [85-91]. However, the exact etiology of WAD is unknown, with multiple soft-tissue structures likely contributing to WAD symptoms. Suspected Spine Trauma Imaging has been found to be of little usefulness in diagnosing and predicting prognosis of WAD [85,86,88,89,92-97]. As such, the diagnosis and prognosis assessment of WAD is based almost exclusively on clinical and psychosocial data. Imaging can be of clinical utility in this population by excluding delayed presentation of cervical spine instability missed during the initial cervical spine evaluation and allowing patients to begin exercise and mobilization of the cervical spine, which has been shown to be effective in reducing symptoms of acute and chronic WAD [98,99]. CT Myelography Cervical Spine There is no role for CT myelography in the assessment of patients with persistent pain on follow-up visit with cervical collar in place. CT Cervical Spine There is no role for CT in the assessment of patients with persistent pain on follow-up visit with cervical collar in place. CTA Head and Neck There is no role for CTA in the assessment of patients with persistent pain on follow-up visit with cervical collar in place. MRI Cervical Spine MRI is the gold standard for imaging diagnosis of traumatic soft-tissue injuries of the neck.
Suspected Spine Trauma PCAs. Includes whiplash associated disorders. It is not uncommon for patients to report persistent neck symptoms after sustaining blunt cervical trauma, even in light of negative initial cervical spine imaging. Neck pain and stiffness, mechanical symptoms (ie, decreased range of motion, point tenderness), and neurologic symptoms frequently persist for months after sustaining cervical trauma and constitute a spectrum of cervical spine injuries commonly referred to as whiplash associated disorders (WAD) [84]. Many different structures have been hypothesized as the source of pain in WAD, most notably the paraspinal muscles, facets, discs, and craniocervical ligaments [85-91]. However, the exact etiology of WAD is unknown, with multiple soft-tissue structures likely contributing to WAD symptoms. Suspected Spine Trauma Imaging has been found to be of little usefulness in diagnosing and predicting prognosis of WAD [85,86,88,89,92-97]. As such, the diagnosis and prognosis assessment of WAD is based almost exclusively on clinical and psychosocial data. Imaging can be of clinical utility in this population by excluding delayed presentation of cervical spine instability missed during the initial cervical spine evaluation and allowing patients to begin exercise and mobilization of the cervical spine, which has been shown to be effective in reducing symptoms of acute and chronic WAD [98,99]. CT Myelography Cervical Spine There is no role for CT myelography in the assessment of patients with persistent pain on follow-up visit with cervical collar in place. CT Cervical Spine There is no role for CT in the assessment of patients with persistent pain on follow-up visit with cervical collar in place. CTA Head and Neck There is no role for CTA in the assessment of patients with persistent pain on follow-up visit with cervical collar in place. MRI Cervical Spine MRI is the gold standard for imaging diagnosis of traumatic soft-tissue injuries of the neck.