Fact or Fiction? MRI of Alar Ligaments and Craniocervical Junction Joints in Whiplash Syndrome

Whiplash injury of the cervical spine is a frequent issue in medical expertises and causes enormous consequential costs for motor insurance companies. Some authors accuse posttraumatic changes of alar ligaments to be causative of consequential disturbances, although biomechanical experiments achieve contradictory results and neuropsychiatric studies do not support this thesis. MRI provides excellent visualization of alar ligaments. However, signal alterations of alar ligaments must be differentiated from common normal variants. Functional MRI provides no diagnostic yield.ZusammenfassungDas Schleudertrauma ist häufig Gegenstand medizinischer Gutachten verschiedener Fachgebiete, und es verursacht enorme Folgekosten bei Kfz-Haftpflichtversicherungen. Posttraumatische Veränderungen der Ligamenta alaria werden von einigen Autoren als ursächlich für chronische Beschwerden nach einer Beschleunigungsverletzung der Halswirbelsäule (HWS) angesehen. Dem widersprechen biomechanische Studien, die bei Beschleunigungsversuchen mit Leichenpräparaten keine entsprechenden Verletzungen erzeugen können. Neuropsychiatrische Untersuchungen können diese Theorie ebenfalls nicht stützen. In der MRT sind die Ligamenta alaria sehr gut darstellbar, jedoch müssen morphologische Veränderungen von Normvarianten abgegrenzt werden. Funktionsuntersuchungen in der MRT bieten keinen diagnostischen Vorteil.

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