Whiplash associated disorders – subjective complaints vs clinical and objective findings. A retrospective study of 866 patients

Abstract

The subjective complaints of 866 WAD (whiplash associated disorders) patients were recorded at a follow-up examination some 32 months after the accident. The complaints were compared to a number of relatively objective examinations – X-ray, CT, MRI, EMG, Bone scan, and clinical assessment.

Neck pain and radiating pain to the limbs were the major complaints. The big majority of the X-rays findings, both primary and late (98%), were found either non-pathological or indicating degenerative changes and old fractures. All positive CT and MRI findings not related to known degenerative changes and old fractures were considered relevant. Bone-scan and clinical findings not related to old injuries were considered to be relevant to the WAD. Positive EMG findings were considered relevant except for those related with incidental CTS. Comparing the various testing modalities, CT and EMG were found positive in 25% and 33% of the tested sample (11% and 12% of the whole WAD patients), accordingly. Bone-scan and MRI were conducted in a much smaller sample of the patients, and only 33% and 25% (3% and 2% of the whole population) were found pathologic, accordingly. Clinically, C-C (chin-chest touch) and RoM tests identified 75 (9%) and 58 (7%) of the pathologic population, accordingly. Excluding degenerative changes and incidental CTS, only 25% of the patients had any objective supporting findings.