title: Mechanisms underlying chronic whiplash: contributions from an incomplete spinal cord injury?
abstract: OBJECTIVE
  To explore the association between findings on advanced, but available, magnetic resonance imaging (MRI) sequences of the cervical spinal cord and muscular system, in tandem with biomechanical measures of maximum volitional plantar flexion torques as a proxy for a mild incomplete spinal cord injury.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  University research laboratory.
  
  
  METHODS
  Three patients with chronic whiplash and one patient with history of whiplash injury but no current symptoms.
  
  
  METHODS
  We measured lower extremity muscle fat, morphological changes in descending spinal cord pathways with advanced MRI applications and maximal activation of the plantar flexors.
  
  
  RESULTS
  Larger magnitudes of lower extremity muscle fat corresponded to altered spinal cord anatomy and reductions in the ability to maximally activate plantar flexor torques in the three subjects with chronic whiplash. Such findings were not present in the recovered participant.
  
  
  CONCLUSIONS
  The potential value of MRI to quantify neuromuscular degeneration in chronic whiplash is recognized. Larger scaled prospective studies are warranted before stronger conclusions can be drawn.
authors.affiliation: Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Elliott
authors.forename: Julius P A
authors.initials: JP
authors.lastname: Dewald
authors.forename: T George
authors.initials: TG
authors.lastname: Hornby
authors.forename: David M
authors.initials: DM
authors.lastname: Walton
authors.forename: Todd B
authors.initials: TB
authors.lastname: Parrish
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013119:Spinal Cord Injuries / Q000473:pathology* / Q000503:physiopathology*; D014911:Whiplash Injuries / Q000473:pathology* / Q000503:physiopathology*
keywords: MRI; Neck (Pain); Neurology; Spinal Cord; Whiplash