ABSTRACT
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 (pâ¯< 0.001; right 57.47⯱ 13.82â¯kPa vs. 87.84⯱ 23.23â¯kPa; left 54.4⯱ 12.68â¯kPa vs. 87.21⯱ 26.47â¯kPa). Muscle stiffness in splenius capitis and sternocleidomastoid muscles was not suitable for analysis because of asymmetrical data distribution. Patients with less than 76â¯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 76â¯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.