Fatty infiltrate in the cervical extensor muscles is not a feature of chronic, insidious-onset neck pain

Clin Radiol. 2008 Jun;63(6):681-7. doi: 10.1016/j.crad.2007.11.011. Epub 2008 Jan 31.


Aim: To investigate the presence of fatty infiltrate in the cervical extensor musculature in patients with insidious-onset neck pain to better understand the possible pathophysiology underlying such changes in chronic whiplash-associated disorders (WAD).

Materials and methods: A sample of convenience of 23 women with persistent insidious-onset neck pain (mean age 29.2+/-6.9 years) was recruited for the study. Magnetic resonance imaging (MRI) was used to quantify fatty infiltration in the cervical extensor musculature. Quantitative Sensory Testing (QST; pressure and thermal pain thresholds) was performed as sensory features are present in chronic whiplash. Self-reported pain and disability, as well as psychological distress, were measured using the Neck Disability Index (NDI) and the General Health Questionnaire-28 (GHQ-28), respectively.

Results: Measures were compared with those of a previous dataset of chronic whiplash patients (n=79, mean age 29.7+/-7.8 years). Using a classification tree, insidious-onset neck pain was clearly identified from whiplash (p<0.001), based on the presence of MRI fatty infiltrate in the cervical extensor musculature (0/102 individuals) and altered temperature thresholds (cold; 3/102 individuals).

Conclusion: Fatty infiltrates in the cervical extensor musculature and widespread hyperalgesia were not features of the insidious-onset neck pain group in this study; whereas these features have been identified in patients with chronic WAD. This novel finding may enable a better understanding of the underlying pathophysiological processes in patients with chronic whiplash.

Publication types

  • Comparative Study

MeSH terms

  • Adipose Tissue / pathology*
  • Adolescent
  • Adult
  • Cervical Vertebrae / pathology
  • Chronic Disease
  • Female
  • Humans
  • Hyperalgesia / etiology
  • Hyperalgesia / pathology
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neck Muscles / pathology*
  • Neck Pain / complications
  • Neck Pain / pathology*
  • Pain Threshold
  • Stress, Psychological / etiology
  • Whiplash Injuries / complications
  • Whiplash Injuries / pathology*