The diagnosis of whiplash remains clinical. The mechanism of injury must be elicited. The clinical syndrome of whiplash and WAD includes :
• Neck pain with the presence of decreased active range of neck movement and local mechanical hyperalgesia within the cervical spine
• Changes in motor function with kinaesthetic disturbances
• Disturbances in kinaesthetic awareness, balance and eye movement control
• Arm pain and paresthesias with numbness and tingling
• Temporomandibular dysfunction
• Headache
• Visual disturbances-blurred vision
• Difficulty swallowing
• Memory and concentration problems
• Psychological distress.

Radiographic diagnosis
The role of imaging in the evaluation of WAD patients is determined by the extent of injury and the stage that the patient is in ( acute v.s chronic). For the acute WAD patient, plain film imaging is the first step to rule in or out more significant injury, such as fracture, dislocation, or instability, and can prompt further imaging if necessary. If there is clinical suspicion of instability , flexion and extension views in the lateral position are warranted .Advanced imaging, such as CT or MRI , in the acute setting is indicated if significant injury has occurred and further evaluation is needed. For the chronic WAD patient, MRI may be warranted for evaluation of the alar and transverse ligaments and the cervical extensor musculature. Kinematic MRI can evaluate for abnormal motion that may have not been measurable by plain film.

plane-films-of-whiplash-injury