Whiplash injury: Difference between revisions

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==Background==
==Background==
[[File:Anatomy of the Neck Sagittal Color MRI.png|thumb|Neck ligament anatomy. A: Anterior atlantooccipital membrane, B: Apical ligament of dens, C: Cruciate ligament of atlas, D: Tectorial membrane of atlanto-axial joint, E: Anterior longitudinal ligament, F: Posterior longitudinal ligament, G: Posterior atlanto-occipital membrane, H: Ligamenta flava, I:Nuchal ligament , J: Supraspinous ligament]]
*Also known as Acute Cervical Strain
*Also known as Acute Cervical Strain
*Sudden acceleration-deceleration trauma that occurs when car is rear-ended
*Sudden acceleration-deceleration trauma that occurs when car is rear-ended


==Clinical Features==
==Clinical Features==
*Pain, stiffness, paracervical muscle tenderness
*[[neck pain|Pain]], stiffness, paracervical muscle tenderness
*Isolated cervical strain should have ''normal'' [[neuro exam]]


==Differential Diagnosis==
==Differential Diagnosis==
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==Evaluation==
==Evaluation==
Diagnosis by history and physical exam
*Clinical diagnosis by history and physical exam
*Use [[C-Spine (NEXUS)]] criteria to determine whether imaging is required
*Consider brain, cord, carotid/vertebral artery dissection if neuro findings are present


==Management==
==Management==
*Use [[C-Spine (NEXUS)]] criteria to determine whether imaging is required
*Symptomatic treatment e.g. [[ibuprofen]]
*Consider brain, cord, carotid/vertebral artery dissection if neuro findings are present
*Studies have shown worsened range of motion and pain scores at 1 and 6 months after whiplash injury with placement of non-rigid (soft) cervical collars<ref>The role of non-rigid cervical collar in pain relief and functional restoration after whiplash injury: a systematic review and a pooled analysis of randomized controlled trials Ricciardi L, Stifano V, D’Arrigo S, et al. Eur Spine J. 2019;28(8):1821-1828.</ref>


==Disposition==
==Disposition==
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[[Category:Trauma]]
[[Category:Trauma]]
[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Sports Medicine]]

Latest revision as of 20:23, 13 November 2024

Background

Neck ligament anatomy. A: Anterior atlantooccipital membrane, B: Apical ligament of dens, C: Cruciate ligament of atlas, D: Tectorial membrane of atlanto-axial joint, E: Anterior longitudinal ligament, F: Posterior longitudinal ligament, G: Posterior atlanto-occipital membrane, H: Ligamenta flava, I:Nuchal ligament , J: Supraspinous ligament
  • Also known as Acute Cervical Strain
  • Sudden acceleration-deceleration trauma that occurs when car is rear-ended

Clinical Features

  • Pain, stiffness, paracervical muscle tenderness
  • Isolated cervical strain should have normal neuro exam

Differential Diagnosis

Neck Trauma

Evaluation

  • Clinical diagnosis by history and physical exam
  • Use C-Spine (NEXUS) criteria to determine whether imaging is required
  • Consider brain, cord, carotid/vertebral artery dissection if neuro findings are present

Management

  • Symptomatic treatment e.g. ibuprofen
  • Studies have shown worsened range of motion and pain scores at 1 and 6 months after whiplash injury with placement of non-rigid (soft) cervical collars[1]

Disposition

  • Generally outpatient management

See Also

External Links

References

  1. The role of non-rigid cervical collar in pain relief and functional restoration after whiplash injury: a systematic review and a pooled analysis of randomized controlled trials Ricciardi L, Stifano V, D’Arrigo S, et al. Eur Spine J. 2019;28(8):1821-1828.