Pain in the neck for a rheumatologist: IN MY OPINION I

Abstract

Rheumatologists are frequently asked to see whiplash patients for an independent medical examination. There are many diagnostic and other assessment issues which arise in the setting of an independent assessment, and which do not usually arise in the usual physician-patient relationship. This article thus reviews aspects of the history, physical examination, radiological evaluation, and causation by way of the accident that are of importance to the rheumatologist as independent examiner. We address questions such as Was a physical injury likely to have occurred in the accident? What are the pertinent psychosocial aspects in the history? What are useful diagnostic signs on examination? and What is the significance of radiological findings? These are important and sometimes troublesome questions to answer in the setting of the independent medical examination, but rheumatologists can look to recent literature and research findings to assist in answering these questions.