Objective sonographic measures for characterizing myofascial trigger points associated with cervical pain
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVES: The purpose of this study was to determine whether the physical properties and vascular environment of active myofascial trigger points associated with acute spontaneous cervical pain, asymptomatic latent trigger points, and palpably normal muscle differ in terms of the trigger point area, pulsatility index, and resistivity index, as measured by sonoelastography and Doppler imaging.
METHODS: Sonoelastography was performed with an external 92-Hz vibration in the upper trapezius muscles in patients with acute cervical pain and at least 1 palpable trigger point (n = 44). The area of reduced vibration amplitude was measured as an estimate of the size of the stiff myofascial trigger points. Patients also underwent triplex Doppler imaging of the same region to analyze blood flow waveforms and calculate the pulsatility index of blood flow in vessels at or near the trigger points.
RESULTS: On sonoelastography, active sites (spontaneously painful with palpable myofascial trigger points) had larger trigger points (mean ± SD, 0.57 ± 0.20 cm(2)) compared to latent sites (palpable trigger points painful on palpation; 0.36 ± 0.16 cm(2)) and palpably normal sites (0.17 ± 0.22 cm(2); P < .01). Analysis of receiver operating characteristic curves showed that area measurements could robustly distinguish between active, latent, and normal sites (areas under the curve, 0.9 for active versus latent, 0.8 for active versus normal, and 0.8 for latent versus normal, respectively). Doppler spectral waveform data showed that vessels near active sites had a significantly higher pulsatility index (median, 8.3) compared to normal sites (median, 3.0; P < .05).
CONCLUSIONS: The results presented in this study show that myofascial trigger points may be classified by area using sonoelastography. Furthermore, monitoring the trigger point area and pulsatility index may be useful in evaluating the natural history of myofascial pain syndrome.
- “Assessment of myofascial trigger points (MTrPs): a new application of ultrasound imaging and vibration sonoelastography,” Sikdar et al, Conf Proc IEEE Eng Med Biol Soc, 2008.
- “Novel applications of ultrasound technology to visualize and characterize myofascial trigger points and surrounding soft tissue,” Sikdar et al, Archives of Physical Medicine & Rehabilitation, 2009.
- “Ultrasonic characterization of the upper trapezius muscle in patients with chronic neck pain,” Turo et al, Ultrason Imaging, 2013.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
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