Ultrasound Detects Pathology In Patients With Whiplash

August 16, 1997

WINSTON SALEM, NC-- Researchers believe they have a new cost-effective imaging technique for evaluating the soft tissues of the spine.

Investigators at Ultrasound Diagnostic Services Inc., in Cleveland, Ohio, have found that ultrasound is a valuable imaging technique for evaluating patients with whiplash -- which doctors call post-traumatic neck pain -- and low back pain.

They are able to detect disc bulges and herniations and other abnormalities of the joints and muscles using real-time ultrasonography.

These preliminary findings could have a major impact in the cost-effective evaluation of patients with spine injuries, according to Gary A. Kirsch, RVT, RDCS, and Dr. Virginia Poirier. They will report their findings at the International Neurosonology '97 meeting on August 16. The meeting is sponsored by the World Federation of Neurology and the Bowman Gray School of Medicine of Wake Forest University.

Kirsch, a co-founder and technical director at Ultrasound Diagnostic Services, has observed the benefits of ultrasound in the evaluation of spinal and paraspinal pathology during the past three years.

The investigators have used ultrasound in more than 1,000 cases with post-traumatic spine injury in which the patients' pain has been difficult to evaluate clinically. They have been able to accurately diagnose disc bulges/herniations, facet joint effusions and injury to the paraspinous muscles.

The disc pathology has been correlated with MRI. Other soft tissue abnormalities are often difficult to detect on any other type of imaging technique.

This type of diagnostic tool may help in cases when it is difficult to objectively document a clinical problem. Health-care plans are often more willing to pay for an ultrasound, than for an MRI, which is very costly in comparison.

Additionally, Kirsch said that there are also potentially significant dynamic changes that can be seen, measured and evaluated using ultrasound such as duplex real-time ultrasound. Among these changes are the presence or absence of normal pulsation of the cerebrospinal fluid within the thecal sac. Small arteries and veins around the spinal cord can be visualized, which "could have an important impact in research of spinal cord injuries."

Another benefit to the ultrasound is its ability to get around obstacles, such as surgical hardware, which can severely degrade image quality with conventional MRI and CT studies of the spine.

In a separate presentation, the investigators will report on the ultrasound observation of muscular fasciculation. This may be of use in evaluation of neuromuscular disorders. Ultrasound could help localize the appropriate muscle for biopsy or electromyogram (EMG) evaluation. EMG is a diagnostic procedure in which doctors place needles in the patient.

For further information, call Mark Wright (email: mwright@bgsm.edu) or Bob Conn (email: rconn@bgsm.edu) at 910-716-4587. Once International Neurosonology '97 has begun on August 13, call the conference press room at 910-724-6923.

Wake Forest Baptist Medical Center

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