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Evidence for increased magnetic resonance imaging signal intensity and morphological changes in the brachial plexus and median nerves of patients with chronic arm and neck pain following whiplash injury
journal contribution
posted on 2023-06-09, 12:11 authored by Jane Greening, Kamakshi Anantharaman, Rupert YoungRupert Young, Andrew DilleyAndrew DilleyBACKGROUND: Whiplash following a motor vehicle accident can result in chronic neck and arm pain. Patients frequently present with cutaneous hypersensitivities and hypoesthesia but without obvious clinical sign of nerve injury. T2-weighted magnetic resonance imaging (MRI) has previously been used to identify nerve pathology. OBJECTIVES: To determine whether there are signs of peripheral nerve pathology on MRI in patients with chronic arm and neck pain following whiplash injury. METHODS: This study used T2-weighted MRI to examine the brachial plexus and median nerve in patients and age-matched healthy control subjects. Clinical examination included tests of plexus and nerve trunk mechanical sensitivity. RESULTS: T2 signal was greater in the brachial plexus and median nerve at the wrist in the patient group (mean intensity ratio = 0.52 (0.13 SD) and 2.09 (0.33 SD) respectively) compared to the control group (mean intensity = 0.45 (0.07 SD) and 1.38 (0.31 SD) respectively; p<0.05). Changes in median nerve morphology were also observed, which included an enlargement (mean area = 8.05 (1.29 SD) mm2 in the patient group and 6.52 (1.08 SD) mm2 in the control group; p<0.05) and flattening at the proximal carpal row (mean aspect ratio = 2.46 (0.53 SD) in the patient group and 1.62 (0.30 SD) in the control group; p < 0.05). All patients demonstrated signs of nerve trunk mechanical sensitivity. CONCLUSION: These findings suggest that patients with chronic whiplash may have inflammatory changes and/or mild neuropathy, which may contribute to symptoms.
History
Publication status
- Published
File Version
- Accepted version
Journal
Journal of Orthopaedic & Sports Physical TherapyISSN
0190-6011Publisher
Journal of Orthopaedic and Sports Physical TherapyExternal DOI
Issue
7Volume
48Page range
523-532Department affiliated with
- BSMS Neuroscience Publications
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- No
Peer reviewed?
- Yes
Legacy Posted Date
2018-02-16First Compliant Deposit (FCD) Date
2018-02-16Usage metrics
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