Whiplash Injury: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Neck/neck/shoulder region [possible symptoms (grade 1, 2): forced posture due to pain; neck pain; myogelosis (knot-like or bulge-like, clearly circumscribed hardening in the muscles; also colloquially known as hard tension)]
      • Skin and the mucous membranes
      • Abdomen (abdomen)
        • Shape of the abdomen?
        • Skin color? Skin texture?
        • Efflorescences (skin changes)?
        • Pulsations? Bowel movements?
        • Visible vessels?
        • Scars? Hernias (fractures)?
    • Auscultation (listening) of the heart.
    • Auscultation of the lungs
    • Palpation (palpation) of the abdomen (abdomen) (pressure pain?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?) [due topossible symptoms (grade 1, 2): nausea (nausea)/vomiting].
  • If necessary, ophthalmological examination [due topossible symptom (only from grade 3): visual disturbances].
  • If necessary, ENT medical examination [due topossible symptom (grade 1): tinnitus (ringing in the ears)]
  • Neurological examination – including strength/reflex testing [due topossible symptom (grade 1, 2):
    • Cephalgia (headache).
    • Insomnia (sleep disturbance)
    • Vertigo (dizziness)

    due topossible symptoms (grade 3):

    • Gait unsteadiness
    • Paresthesias (false sensations) in the arms/hands and/or head.
    • Vigilance disorders (disorders of consciousness in which sustained attention (vigilance) is impaired)]

    [due topossible sequelae:

    • Atlantooccipital dislocation – displacement of the first cervical vertebra and skull bone.
    • Intervertebral disc injuries, unspecified
    • Commotio spinalis (spinal cord concussion).
    • Compressio spinalis (spinal cord compression)
    • Contusio spinalis (spinal cord contusion)
    • Dens axis fracture – fracture of the second cervical vertebra.
    • Retropharyngeal hematoma – bruise localized between the cervical spine and the posterior pharyngeal wall.
    • Spinal cord injury, unspecified
    • Traumatic brain injury (TBI)
    • Spinal nerve injuries
    • Vertebral body fractures (fractures of the vertebral body)
    • Vertebral arch fractures (vertebral arch fractures)
    • Vertebral joint process fractures
    • Vertebral luxation (dislocation of the vertebrae)
    • Paraplegia]
  • Psychiatric examination – for symptoms of an acute stress reaction (e.g., intrusion/uncontrollable recurrent, agonizingly conscious recollection and reliving of traumatic events, anxiety)

Square brackets [ ] indicate possible pathological (pathological) physical findings.