title: Magnetic resonance imaging findings of fatty infiltrate in the cervical flexors in chronic whiplash.
abstract: METHODS
  Retrospective investigation of muscle changes in patients suffering from chronic whiplash-associated disorders (WAD).
  
  
  OBJECTIVE
  To quantitatively compare the presence of muscle alterations (fatty infiltrate [MFI] and cross-sectional area [CSA]) in the anterior musculature of the cervical spine in a cohort of chronic whiplash patients (WAD II) and healthy control subjects across muscle and cervical segmental level.
  
  
  BACKGROUND
  Magnetic resonance imaging can be regarded as the gold standard for muscle imaging. There is little knowledge about in vivo features of anterior neck muscles in patients suffering from chronic WAD and how muscle structure differs across the factors of muscle, vertebral level, age, self-reported pain and disability, body mass index, and duration of symptoms.
  
  
  METHODS
  Reliable magnetic resonance imaging measures for MFI and CSA were performed for the anterior cervical muscles bilaterally in 109 female subjects (78 WAD, 31 healthy control; 18-45 years, 3 months to 3 years postinjury). The measures were performed on all subjects for the longus capitis and colli and the sternocleidomastoid muscles.
  
  
  RESULTS
  The WAD subjects had significantly larger MFI and CSA for the anterior muscles compared to healthy control subjects (all P < 0.0001). In addition, the amount of MFI varied by both cervical level and muscle, with the longus capitis/colli having the largest amount of fatty infiltrates at the C2-C3 level (P < 0.0001). MFI was inversely related to age, self-reported pain/disability, and body mass index but directly proportional to duration of symptoms.
  
  
  CONCLUSIONS
  There is significantly greater MFI and CSA in the anterior neck muscles, especially in the deeper longus capitis/colli muscles, in subjects with chronic WAD when compared to healthy controls. Future studies are required to investigate the relationships between muscular morphometry and symptoms in patients suffering from acute and chronic WAD.
authors.affiliation: Centre for Clinical Research in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Division of Physiotherapy, The University of Queensland, Brisbane, Australia. j.elliott2@uq.edu.au
authors.forename: James M
authors.initials: JM
authors.lastname: Elliott
authors.forename: Shaun
authors.initials: S
authors.lastname: O'Leary
authors.forename: Michele
authors.initials: M
authors.lastname: Sterling
authors.forename: Joan
authors.initials: J
authors.lastname: Hendrikz
authors.forename: Ashley
authors.initials: A
authors.lastname: Pedler
authors.forename: Gwen
authors.initials: G
authors.lastname: Jull
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002574:Cervical Vertebrae / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009334:Neck Muscles / Q000473:pathology*; D010147:Pain Measurement; D012189:Retrospective Studies; D014911:Whiplash Injuries / Q000473:pathology*