Imaging is the conventional approach to finding evidence of injury. When major trauma to the neck results in fractures or dislocations, these are typically evident on plain radiographs of the neck. Computed tomography (CT) can provide more detailed reconstructions of the injury. Magnetic imaging resonance (MRI) can reveal soft tissue components or consequences of the injury. Minor injuries to the neck do not result in major fractures or dislocations. Therefore, such injuries are not evident on imaging. Indeed, conventional imaging is typically normal. This lack of evidence of injury on imaging is used by some commentators to infer that there is no injury. That is false. The lack of evidence only reflects the limited resolution on conventional imaging. Plain radiographs or CT demonstrate only lesions in bone; they do not show soft tissue injuries. MRI demonstrates soft tissues, but it will not necessarily reveal small lesions. Normal imaging, therefore, does not exclude the presence of lesions that are beyond the resolution of the imaging technique used. Meanwhile, two lines of evidence have shown that lesions can and do occur, after minor injuries to the neck. Postmortem studies have shown the types of lesions that can and might occur. Clinical studies have shown the sites at which these lesions must be present.
Interventional Spine: an Algorithmic Approach p. 589-592