Kumbhare Dinesh, Shaw Saurabh, Grosman-Rimon Liza, Noseworthy Michael D
Division of Physical Medicine and Rehabilitation, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
Departments of Psychology, McMaster University, Hamilton, Ontario, Canada.
J Ultrasound Med. 2017 Dec;36(12):2559-2568. doi: 10.1002/jum.14308. Epub 2017 Jul 3.
Myofascial pain syndrome is one of the most common causes of chronic pain and is highlighted by the presence of myofascial trigger points. The current practice of diagnosing myofascial pain syndrome among clinicians involves manual detection of myofascial trigger points, which can be inconsistent. However, the detection process can be strengthened with the assistance of ultrasound (US). Therefore, this study aimed to characterize the upper trapezius by using quantitative techniques in healthy asymptomatic individuals with neck pain.
Study participants were recruited on the basis of the inclusion and exclusion criteria established, and US images of the trapezius, along the axial and longitudinal orientations, were obtained. Each set was obtained by 2 investigators: experienced and inexperienced personnel.
Fifteen participants were recruited. The mean gray scale US echo intensity distribution obtained was 41.9. A paired t test of the global mean echo intensity value obtained for each image from the US operators did not show any significant difference (P = .77). A t test was performed, comparing the echo intensity of the group of patients with neck pain and healthy control participants, and the difference was found to be significant (P = .052). The median blob area was 2.71. The quartile range for the blob area was 1.72 for the 25th percentile to 4.90 for the 75th percentile.
This study demonstrated that quantitative analysis of the echo intensity of US images can provide important information. However, further research is necessary to explore the relationships among sex, age, blob area, count, body mass index, regional anatomy, and extent of training or exercise of the particular muscle.
肌筋膜疼痛综合征是慢性疼痛最常见的病因之一，其特征为存在肌筋膜触发点。临床医生目前诊断肌筋膜疼痛综合征的方法是手动检测肌筋膜触发点，这种方法可能存在不一致性。然而，借助超声（US）可加强检测过程。因此，本研究旨在通过定量技术对无症状颈部疼痛的健康个体的斜方肌上部进行特征描述。
根据既定的纳入和排除标准招募研究参与者，并获取斜方肌轴向和纵向的超声图像。每组图像由两名研究者获取：经验丰富者和经验不足者。
招募了15名参与者。获得的平均灰度超声回声强度分布为41.9。对超声操作者从每张图像获得的全局平均回声强度值进行配对t检验，未显示出任何显著差异（P = 0.77）。进行t检验，比较颈部疼痛患者组和健康对照参与者的回声强度，发现差异具有统计学意义（P = 0.052）。斑点面积中位数为2.71。斑点面积的四分位数间距为：第25百分位数为1.72，第75百分位数为4.90。
本研究表明，对超声图像的回声强度进行定量分析可提供重要信息。然而，有必要进一步研究以探索性别、年龄、斑点面积、数量、体重指数、局部解剖结构以及特定肌肉的训练或运动程度之间的关系。
