OBJECTIVETo investigate and analyze the characteristics of Meridian Sinew (Jingjin) syndrome in patients with whiplash-associated disorders (WAD).

METHODSFrom August 2010 to September 2011, 313 WAD cases from New York and California states were collected. The survey mostly collects the information of "Sinew Knotted Points" and symptoms of four types of Meridian Sinew differentiation-Taiyang, Shaoyin, Shaoyang and Yangming.

RESULTSAmong the cases which are on the average of medium injury level, the higher frequency of "Sinew Knotted Points" tenderness were found on Jianwaishu (SI 14), Jianzhongshu (SI 15), Tianchuang (SI 16), C3-6 Spinous Process, Dazhui (GV 14), Fengchi (GB 20), Tianliao (SJ 15) and Tianding (LI 17). The most commonly presented symptoms were widespread spasm and tenderness in the neck (Taiyang), difficulty in lateral flexion (Shaoyang), problems of extension and flexion (Taiyang), and stiffness and pain during neck movement (Yangming). Among the cases, 237 cases (75.72%) were related to Taiyang Meridian Sinew syndrome, 82 cases (26.20%) to Shaoyin syndrome and 175 (55.91%) and 176 (56.23%) cases to Shaoyang and Yangming syndrome respectively. The most of cases presented in a combination format. The syndrome distribution under Grade I, II and III reflected that more combination of the Meridian Sinew syndromes in the whiplash injury patients which is resulted from more severity of injury.

CONCLUSIONIt is practical to identify the location of abnormality through Meridian Sinew differentiation, considering both "Sinew Knotted Points" tenderness and corresponding symptoms, for the local neck symptoms of WAD.

Whiplash injury is a common injures in our daily lives, but the mechanism of it and the best treatment is largely unknown. The development of chronic pain and disability following whiplash injury is not uncommon and results in substantial social and economic costs. Clinical manifestation and recovery time are difference, which make it difficult for doctor diagnosis and treatment. The current study have shown that the social class, severity of collision, compensation and lawsuit, physical and psychological factors were relevant predictors for the outcome of whiplash. This article is try to overview the status quo of the whiplash injury.
Cervical Vertebrae ; injuries ; Humans ; Prognosis ; Whiplash Injuries ; diagnosis ; pathology ; physiopathology ; therapy

Adult ; Aged ; Cervical Vertebrae ; injuries ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Whiplash Injuries ; diagnosis

OBJECTIVE: The name of whiplash Injury derives from the etiopathogenic description of the sudden sharp whipping movement of the head and neck, symptoms are varied, manifesting as neck pain, occipital pain, dysesthesia, and weakness of arm, and so on. But there is no objective diagnostic tool for the evaluation of its symptoms. The purpose of the study is to visualize the symptomatic region before and after treatment and comparing the images obtained by infrared study. METHODS: From march 2006 to June 2008, 20 patients diagnosed as whiplash injuries were examined by digital infrared thermographic imaging system (DITI, DOREX, USA). The male-to-female ratio was 14:6 and their ages were ranging in age from 20 to 67 years, with mean age of 38.5 years. We evaluated thermal change (deltaT) in lesion area(neck and shoulder) and also compared thermal difference (deltaT (2wk-I)) after pre- & post- treatment. RESULTS: Initial DITI was 34.28 +/- 2.90 on anterior neck, 34.29 +/- 2.98 on posterior neck, 33.42 +/- 2.93 on right shoulder shoulder (Lt), and 33.59 +/- 2.81 on left shoulder. DITI after 2weeks treatment was 33.60 +/- 2.88 on anterior neck, 33.78 +/- 2.99 on posterior neck, 32.79 +/- 2.78 on right shoulder, and 33.05 +/- 2.74 on left shoulder. The thermal difference of lesional area on the initial treatment and after treatment (deltaT (2wk-I)) was 0.68 +/- 0.45 on anterior neck, 0.51 +/- 0.36 on posterior neck, 0.63 +/- 0.32 on right shoulder, and 0.54 +/- 0.64 on left shoulder, and these result were statistically significant (p < 0.05). Thermal difference (deltaT) was neck 0.34 and shoulder 0.33 on initial injury, and 0.39, 0.31 after 2 weeks respectively. This finding was symmetrical and below deltaT 0.5 based on pathologic body temperature. Initial VAS (Visual Analogue Scale) of Neck was 7.9 +/- 0.78 and after 2 weeks was 3.6 +/- 1.21 the initial VAS of shoulder was 7.4 +/- 0.52 and after 2 weeks was 3.2 +/- 0.97. There was statistically significant (p=0.001). CONCLUSION: Therefore DITI was perceived as a reliable tool in the objective assessment of treatment effect after sustaining whiplash injuries, in clinical practice.
Arm ; Body Temperature ; Head ; Humans ; Neck ; Neck Pain ; Paresthesia ; Shoulder ; Whiplash Injuries

STUDY DESIGN: Whiplash injury is a prevalent and often destructive injury of the cervical column, which can lead to serious neck pain. Many approaches have been suggested for the treatment of whiplash injury, including anti-inflammatory drugs, manipulation, supervised exercise, and cervical collars. Cervical collars are generally divided into two groups: soft and rigid collars. PURPOSE: The present study aimed to compare the effect of soft and rigid cervical collars on immobilizing head and neck motion. OVERVIEW OF LITERATURE: Many studies have investigated the effect of collars on neck motion. Rigid collars have been shown to provide more immobilization in the sagittal and transverse planes compared with soft collars. However, according to some studies, soft and rigid collars provide the same range of motion in the frontal plane. METHODS: Twenty-nine healthy subjects aged 18–26 participated in this study. Data were collected using a three-dimensional motion analysis system and six infrared cameras. Eight markers, weighing 4.4 g and thickened 2 cm² were used to record kinematic data. According to the normality of the data, a paired t-test was used for statistical analyses. The level of significance was set at α=0.01. RESULTS: All motion significantly decreased when subjects used soft collars (p<0.01). According to the obtained data, flexion and lateral rotation experienced the maximum (39%) and minimum (11%) immobilization in all six motions using soft collars. Rigid collars caused maximum immobilization in flexion (59%) and minimum immobilization in the lateral rotation (18%) and limited all motion much more than the soft collar. CONCLUSIONS: This study showed that different cervical collars have different effects on neck motion. Rigid and soft cervical collars used in the present study limited the neck motion in both directions. Rigid collars contributed to significantly more immobilization in all directions.
Head* ; Healthy Volunteers* ; Immobilization* ; Neck Pain ; Neck* ; Range of Motion, Articular ; Whiplash Injuries

OBJECTIVE: This study aims to visualize the subjective symptoms before and after the treatment of whiplash injury using infrared (IR) thermography. METHODS: IR thermography was performed for 42 patients who were diagnosed with whiplash injury. There were 19 male and 23 female patients. The mean age was 43.12 years. Thermal differences (DeltaT) in the neck and shoulder and changes in the thermal differences (DeltadT) before and after treatment were analyzed. Pain after injury was evaluated using visual analogue scale (VAS) before and after treatment (DeltaVAS). The correlations between DeltadT and DeltaVAS results before and after the treatment were examined. We used Digital Infrared Thermal Imaging equipment of Dorex company for IR thermography. RESULTS: The skin temperature of the neck and shoulder immediately after injury showed 1-2degrees C hyperthermia than normal. After two weeks, the skin temperature was normal range. DeltaT after immediately injuy was higher than normal value, but it was gradually near the normal value after two weeks. DeltadT before and after treatment were statistically significant (p<0.05). VAS of the neck and shoulder significantly reduced after 2 week (p=0.001). Also, there was significant correlation between DeltadT and reduced DeltaVAS (the neck; r=0.412, p<0.007) (the shoulder; r=0.648, p<0.000). CONCLUSION: The skin temperature of sites with whiplash injury is immediately hyperthermia and gradually decreased after two weeks, finally it got close to normal temperature. These were highly correlated with reduced VAS. IR thermography can be a reliable tool to visualize the symptoms of whiplash injury and the effectiveness of treatment in clinical settings.
Female ; Fever ; Humans ; Male ; Neck ; Reference Values ; Shoulder ; Skin Temperature ; Thermography* ; Whiplash Injuries*

Whiplash injury is a relatively common injury of clinical acupuncture and moxibustion in the United States. The mechanism and clinical manifestation of whiplash injuries as well as its pathogenesis described in TCM were analyzed in this present article. The authors introduced the TCM syndrome differentiation of whiplash injuries and claimed that both the location and the stage of disease should be considered. For the different injury locations, the meridian musculature differentiation was applied to classify the whiplash injuries as Taiyang, Yangming, Shaoyang and Shaoyin Meridian syndromes. Considering the duration of the injury, qi stagnation and blood stasis types were classified in the acute stage and phlegm accumulation, insufficiency of the liver and kidney and qi and blood deficiencies types were classified during the chronic stage. An acupuncture protocol for whiplash injuries and typical cases were also introduced.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Whiplash Injuries ; diagnosis ; therapy

OBJECTIVE: To observe the imaging features for chronic whiplash alar ligament injury in elderly patients and to provide an effective diagnostic method for long-term neck pain and headaches due to alar ligament injury in elderly patients. METHODS: A total of 134 elderly patients, who engaged in the work or activities related to whiplash motion and suffered from chronic neck pain, were enrolled for the study. All patients were performed comprehensive health examination (CT, MR, ultrasound and laboratory examination) and high resolution PDWI. The patients were divided into 2 groups according to the results of comprehensive health examination: a clear etiology group(CE group, n=96) and an unknown etiology group(UE group, n=38). Th e characteristics of PDWI signal in the ligament were analyzed between the 2 groups. RESULTS: Th e anatomy and signal characteristics of the alar ligament were clearly displayed by high resolution PDWI. Th e alar ligaments were effectively displayed by oblique coronal image. In the CE group, 7 patients (7/96) showed the positive sign of ligament injured, while 21 (21/38) patients showed positive sign of ligament injured in the UE group (P<0.01). Chronic whiplash ligament injury was proved to be the reason for long-term neck pain and headaches in 15.7% patients. CONCLUSION Th e whiplash injury of alar ligament is an important reason for chronic neck pain in elderly patients. High resolution PDWI is an effective method to evaluate the image features of alar ligament and can provide an accurate diagnosis for chronic neck pain and headaches caused by the alar ligament whiplash injury.
Aged ; Cervical Vertebrae ; Chronic Pain ; Fascia ; Humans ; Ligaments ; pathology ; Magnetic Resonance Imaging ; Whiplash Injuries ; diagnosis

A 45-year-old male car driver died in a traffic accident of four cars rear-end collision on the highway. He was found to have died after a respiratory and cardiac arrest at the scene. No sign of skin injuries was observed from the external inspection. The autopsy was not permitted by the family members because of the local culture. Multislice computed tomography (MSCT) was applied to the current case, showing dislocation of C3-4 cervical vertebrae with II degree, C4 vertebral plate fractures, and spinal stenosis. Post-mortem MSCT confirmed the diagnosis as whiplash injuries. MSCT was verified to be effective in showing the severity of whiplash injuries, thus providing certain objective evidence for medicolegal expertise.
Accidents, Traffic ; Autopsy ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; Spinal Fractures ; Whiplash Injuries/diagnostic imaging*

Intervertebral disc herniation is rare in children and is reportedly related with disc calcification and traumatic injury. We report an 8 years old girl, who complained of tingling sensation in both arms and intentional tic like neck stretching for about 1 month. She had got unnoticed whiplash Injury 2 weeks before symptoms. She also had been taking lessons for taekwondo for one and half year. Physical examination was unremarkable. Her symptoms got aggravated over the next 4 weeks. Plain vertebral x-ray showed no abnormalities, but cervical spinal MRI revealed disc central herniations at C 5-6 and C 6-7 levels. We concluded that her paresthesia and tic like motion were related with cervical disc herniation from hyperflexion neck injury.
Arm ; Child ; Humans ; Intervertebral Disc ; Neck ; Neck Injuries ; Paresthesia ; Physical Examination ; Sensation ; Tic Disorders ; Tics ; Whiplash Injuries