Knowledge of etiological mechanisms underlying whiplash-associated disorders is incomplete. Localisation and quantification of peripheral musculoskeletal injury and
inflammation in whiplash-associated disorders would facilitate diagnosis, strengthen patients' subjective
pain reports, and aid clinical decisions, all of which could lead to improved treatment. In this longitudinal observational study, we evaluated combined [11C]-D-
deprenyl positron emission tomography and computed tomography after acute
whiplash injury and at 6-month follow-up. Sixteen adult patients (mean age 33 years) with
whiplash injury grade II were recruited at the emergency department. [11C]-D-
deprenyl positron emission tomography and computed tomography, subjective
pain levels, self-rated neck disability, and active cervical range of motion were recorded within 7 days after injury and again at 6-month follow-up. Imaging results showed possible tissue
injuries after acute whiplash with an altered [11C]-D-
deprenyl uptake in the cervical bone structures and facet joints, associated with subjective
pain locale and levels, as well as self-rated disability. At follow-up, some patients had recovered and some showed persistent symptoms and reductions in [11C]-D-
deprenyl uptake correlated to reductions in
pain levels. These findings help identify affected peripheral structures in
whiplash injury and strengthen the idea that positron emission tomography and computed tomography detectable organic lesions in peripheral tissue are relevant for the development of persistent
pain and disability in
whiplash injury.