Localized cervical pain: advantages and limits of ultrasound evaluation

PURPOSE: Cervical pain is very frequent in the general population. In clinical practice, plain X-ray and, in selected cases, computed tomography or magnetic resonance imaging, are performed. However, the feasibility and utility of ultrasound examination have been poorly investigated. Aim of the present study was to evaluate whether ultrasound could be useful in the diagnosis of localized cervical pain. METHODS: Subjects suffering from posterior cervical pain without irradiation to surrounding tissues were enrolled. After clinical and functional evaluation (demographic and anthropometric data, VAS at rest and during neck movements, symptoms duration, and characteristics of pain onset [atraumatic or traumatic]), an ultrasound exam of the cervical spine was performed according to standard protocols. RESULTS: The anatomic structures of the neck district were visualized in 124/127 enrolled patients and pathological features were observed in 58. Significant ultrasound differences were registered between the patients with traumatic and atraumatic onset of neck pain. In the first group, articular effusion, capsular bulging, disalignment and avulsion of the articular apex were observed, whereas in the latter cortical irregularities, osteophytosis, and articular ankylosis were prevalent. CONCLUSIONS: Ultrasound examination can be used as diagnostic tool in the evaluation of selected patients suffering from localized cervical pain, particularly in cases of pain due to traumatic injuries. KEYWORDS: Cervical spine; Pain; Trauma; Ultrasound; Whiplash