title: Cervical muscle area measurements in whiplash patients: Acute, 3, and 6 months of follow-up.
abstract: OBJECTIVE
  To investigate the role of the cervical spine muscles in whiplash injury. We hypothesized that (i) cervical muscle hypotrophy would be evident after a 6-month follow-up and, (ii) cervical muscle hypotrophy would correlate with symptom persistence probably related to pain or inactivity.
  
  
  METHODS
  Ninety symptomatic patients (48 females) were recruited from our emergency department and examined within 48 h, and at 3, and 6 months after a motor vehicle accident. MRI cross-sectional muscle area (CSA) measurements were performed bilaterally of the cervical extensor and sternocleidomastoid muscles using transverse STIR (Short Tau inversion Recovery) sequences at the C2 (deep and total dorsal cervical extensor muscles), C4 (sternocleidomastoid muscles) and C5 (deep and total dorsal cervical extensor muscles) levels. Two blinded raters independently performed the measurements at each time point. First, CSA changes over time were analyzed and, second, CSAs were correlated with clinical outcomes (EuroQuol, Whiplash Disability Score, neck pain intensity [VAS], cervical spine mobility).
  
  
  RESULTS
  There was a high agreement of CSA measurements between the two raters. Women consistently had smaller CSAs than men. There were no significant changes of CSAs over time at any of the three levels. There were no consistent significant correlations of CSA values with the clinical scores at all time points except with the body mass index.
  
  
  CONCLUSIONS
  Our results do not support a major role of cervical muscle volume in the genesis of symptoms after whiplash injury.
authors.affiliation: Department of Radiology, University Hospital, Zurich, Switzerland. erikajulbrich@googlemail.com
authors.forename: Erika J
authors.initials: EJ
authors.lastname: Ulbrich
authors.forename: Ramon
authors.initials: R
authors.lastname: Aeberhard
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wetli
authors.forename: Andre
authors.initials: A
authors.lastname: Busato
authors.forename: Chris
authors.initials: C
authors.lastname: Boesch
authors.forename: Heinz
authors.initials: H
authors.lastname: Zimmermann
authors.forename: Juerg
authors.initials: J
authors.lastname: Hodler
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Anderson
authors.forename: Matthias
authors.initials: M
authors.lastname: Sturzenegger
mesh_terms: D000328:Adult; D019412:Anatomy, Cross-Sectional / Q000379:methods; D002574:Cervical Vertebrae / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009133:Muscular Atrophy / Q000209:etiology* / Q000473:pathology*; D009334:Neck Muscles / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014911:Whiplash Injuries / Q000150:complications* / Q000473:pathology*