The Directorate of Health commissioned the Norwegian Knowledge Centre for the Health Services to assess the use of magnetic resonance imaging (MRI) in detecting instability and ligament damage in patients with whiplash-associated disorders (WAD).
MethodWe developed a search strategy and searched relevant databases for systematic reviews in December 2013 and in June 2014.
The literature search returned 158 hits. Only one systematic review fulfilled the inclusion criteria.
The systematic review on conventional MRI found no differences in MRI signal of the alar and transverse ligaments between patients with WAD and control subjects in a meta-analysis. The results are based on data from case-control studies, and we therefore have low confidence in the documentation.
We also assessed two additional case-control studies that were not included in the meta-analysis. One study on conventional MRI found that patients with acute whiplash injury had thicker transverse ligaments in the neck than control subjects, but the differences were only significant in men. The other study on functional MRI found more abnormal MRI signals from the alar ligaments and more abnormal movements at the upper neck region in patients with chronic whiplash-associated disorders compared to control subjects. Because these are case-control studies with few participants and because we cannot draw conclusions based on one publication alone, the Knowledge Centre has very low confidence in this documentation.