Ability of magnetic resonance elastography to assess taut bands
Three articles on PainSci cite Chen 2008: 1. The Complete Guide to Trigger Points & Myofascial Pain 2. Toxic Muscle Knots 3. The Trigger Point Identity Crisis
PainSci commentary on Chen 2008: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Magnetic resonance elastrography (MRE) can probably show areas of differential stiffness in muscle tissue, as shown in a pilot study by these researchers the previous year.
To further establish the validity of the technique, Chen et al used it on gelatin models of muscle tissue: a chunk of gelatin all of the same consistency, and another chunk containing a core of stiffer gelatin, representing a “taut band.” This confirmed what MRE results look like when examining simple models of tissue stiffness.
MRE was then used to compare muscle tissue in eight people, four healthy, and four with chronic pain presumed to be caused by trigger points. MRE clearly showed regions of stiffness in the patients with pain, but not in the pain-free patients. “This study suggests that magnetic resonance elastography may have a potential for objectively characterizing myofascial taut bands that have been up to now detectable only by the clinician’s fingers.”
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.
BACKGROUND: Myofascial taut bands are central to diagnosis of myofascial pain. Despite their importance, we still lack either a laboratory test or imaging technique capable of objectively confirming either their nature or location. This study explores the ability of magnetic resonance elastography to localize and investigate the mechanical properties of myofascial taut bands on the basis of their effects on shear wave propagation.
METHODS: This study was conducted in three phases. The first involved the imaging of taut bands in gel phantoms, the second a finite element modeling of the phantom experiment, and the third a preliminary evaluation involving eight human subjects-four of whom had, and four of whom did not have myofascial pain. Experiments were performed with a 1.5 T magnetic resonance imaging scanner. Shear wave propagation was imaged and shear stiffness was reconstructed using matched filtering stiffness inversion algorithms.
FINDINGS: The gel phantom imaging and finite element calculation experiments supported our hypothesis that taut bands can be imaged based on its outstanding shear stiffness. The preliminary human study showed a statistically significant 50-100% (P=0.01) increase of shear stiffness in the taut band regions of the involved subjects relative to that of the controls or in nearby uninvolved muscle.
INTERPRETATION: This study suggests that magnetic resonance elastography may have a potential for objectively characterizing myofascial taut bands that have been up to now detectable only by the clinician's fingers.
related content
- “New Views of Myofascial Trigger Points: Etiology and Diagnosis,” David G Simons, Archives of Physical Medicine & Rehabilitation, 2008.
- “Magnetic resonance elastography: a review,” Yogesh K Mariappan, Kevin J Glaser, and Richard L Ehman, Clin Anat, 2010.
- “Microscopic features and transient contraction of palpable bands in canine muscle,” D G Simons and W C Stolov, Am J Phys Med, 1976.
- “Endplate potentials are common to midfiber myofacial trigger points,” David G Simons, Chang-Zern Hong, and Lois Statham Simons, Am J Phys Med Rehabil, 2002.
- “Accelerated muscle fatigability of latent myofascial trigger points in humans,” Hong-You Ge, Lars Arendt-Nielsen, and Pascal Madeleine, Pain Med, 2012.
- “Two-dimensional ultrasound and ultrasound elastography imaging of trigger points in women with myofascial pain syndrome treated by acupuncture and electroacupuncture: a double-blinded randomized controlled pilot study,” Cristina Emöke Erika Müller, Maria Fernanda Montans Aranha, and Maria Beatriz Duarte Gavião, Ultrason Imaging, 2015.
- “Induction of muscle cramps by nociceptive stimulation of latent myofascial trigger points,” Hong-You Ge, Yang Zhang, Shellie Boudreau, Shou-Wei Yue, and Lars Arendt-Nielsen, Exp Brain Res, 2008.
- “Assessment of myofascial trigger points (MTrPs): a new application of ultrasound imaging and vibration sonoelastography,” Siddhartha Sikdar, Jay P Shah, Elizabeth Gilliams, Tadesse Gebreab, and Lynn H Gerber, Conf Proc IEEE Eng Med Biol Soc, 2008.
- “Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome,” Jay P Shah and Elizabeth A Gilliams, Journal of Bodywork & Movement Therapies, 2008.
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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- Exercise and education versus saline injections for knee osteoarthritis: a randomised controlled equivalence trial. Bandak 2022 Ann Rheum Dis.
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- Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Richards 2021 Phys Ther.