Department of Anesthesiology, Clement Zablocki VA Medical Center & Medical College of Wisconsin, Milwaukee, Wisconsin 53295, USA.
Pain Pract. 2013 Jun;13(5):405-8. doi: 10.1111/papr.12002. Epub 2012 Oct 24.
Trigger points can result from a variety of inciting events including muscle overuse, trauma, mechanical overload, and psychological stress. When the myofascial trigger points occur in cervical musculature, they have been known to cause headaches. Ultrasound imaging is being increasingly used for the diagnosis and interventional management of various painful conditions. A veteran was referred to the pain clinic for management of his severe headache following a gunshot wound to the neck with shrapnel embedded in the neck muscles a few years prior to presentation. He had no other comorbid conditions. Physical examination revealed a taut band in the neck. An ultrasound imaging of the neck over the taut band revealed the deformed shrapnel located within the levator scapulae muscle along with an associated trigger point in the same muscle. Ultrasound guided trigger point injection, followed by physical therapy resolved his symptoms. This is a unique report of embedded shrapnel and coexisting myofascial pain syndrome revealed by ultrasound imaging. The association between shrapnel and myofascial pain syndrome requires further investigation.
触发点可由多种激发事件引起，包括肌肉过度使用、创伤、机械过载和心理压力。当肌筋膜触发点发生在颈部肌肉中时，已知会引起头痛。超声成像越来越多地用于各种疼痛疾病的诊断和介入治疗。一位老兵因几年前颈部枪伤导致弹片嵌入颈部肌肉而被转介到疼痛诊所治疗严重头痛。他没有其他合并症。体格检查发现颈部有条紧绷带。在紧绷带上方进行颈部超声成像显示，变形弹片位于斜方肌内，同一肌肉内有一个相关的触发点。超声引导下的触发点注射，随后进行物理治疗，解决了他的症状。这是一个独特的报告，嵌入的弹片和共存的肌筋膜疼痛综合征通过超声成像揭示。弹片和肌筋膜疼痛综合征之间的关联需要进一步调查。
