Most often, following a physical examination, the initial method of assessment in the typical whiplash injury is radiography-standard x-rays. It is the only imaging procedure that would be considered routine. If the patient is to be treated medically only (i.e., with medication as opposed to spinal manipulation or surgery) and the injury appears quite minor, x-rays might not be indicated. If the patient has limited range of motion in the neck at the time of the examination, x-rays should be limited to the standard five-view series. Otherwise-once serious pathology (fracture, dislocation, etc.) have been ruled out-bending views in full flexion and extension should be obtained to assess ligamentous integrity.
When further questions arise concerning the biomechanical function and ligamentous integrity of the neck, videofluoroscopy can often provide important diagnostic information. MRI can also provide information about ligaments, but is more often used in the evaluation of the intervertebral discs. As is the case with plain x-rays, CT-and even MRI-will not have the sufficient resolving power to find many soft tissue injuries. In searching for suspected fractures, clinicians may turn to CT, bone scanning (scintigraphy) or single photon emission computed tomography (SPECT
