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Upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography
BACKGROUND: Myofascial pain syndrome (MPS) is a common cause of neck pain, which is a global public health problem. Because MPS does not present morphological changes within lesioned muscles, there are no imaging diagnostic criteria for this condition. In this study, we evaluate elasticity changes i...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423376/ https://www.ncbi.nlm.nih.gov/pubmed/37581083 http://dx.doi.org/10.21037/qims-22-797 |
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author | Hao, Chang-Juan Kang, Xiao-Yan Kang, Chun-Song Li, Ting-Ting Huo, Jian-Zhong Xu, Qian Xiao, Wen-Li Zhao, Zhe-Xia Ji, Xing-Hua Zhang, Quan-Bin |
author_facet | Hao, Chang-Juan Kang, Xiao-Yan Kang, Chun-Song Li, Ting-Ting Huo, Jian-Zhong Xu, Qian Xiao, Wen-Li Zhao, Zhe-Xia Ji, Xing-Hua Zhang, Quan-Bin |
author_sort | Hao, Chang-Juan |
collection | PubMed |
description | BACKGROUND: Myofascial pain syndrome (MPS) is a common cause of neck pain, which is a global public health problem. Because MPS does not present morphological changes within lesioned muscles, there are no imaging diagnostic criteria for this condition. In this study, we evaluate elasticity changes in upper trapezius muscles most frequently involved in cervical MPS using real-time ultrasound shear-wave elastography, and we examine their potential diagnostic value. METHODS: We consecutively enrolled 109 right posterior neck pain patients for this prospective study. Of these, 51 were diagnosed with MPS and 58 with non-MPS in the right side of their neck. Among MPS patients, 19 fell into the 1–3 range (mild pain) for pain scores on the visual analog scale (VAS), 25 fell into the 4–6 range (moderate pain), and 7 into the 7–10 range (severe pain). MPS was diagnosed by two independent clinicians using the diagnostic criteria proposed by Simons et al. Using real-time ultrasound shear-wave elastography, we measured right trapezius mean shear-wave velocity (SWV(mean)). The midpoint of the line between the foramen magnum and the end of the right acromion served as measuring point. Regions of interest were scaled to span 0–8.0 m/s. RESULTS: Trapezius SWV(mean) was significantly higher in MPS patients compared with non-MPS patients (P<0.001). Stratified analysis of MPS patients according to pain severity revealed similar trapezius SWV(mean) between mild pain and non-MPS patients (P=0.324), however SWV(mean) was higher in moderate and severe pain MPS patients compared with non-MPS patients (P<0.001). The area under the curve (AUC) value for upper trapezius SWV(mean) in MPS patients was 0.791 (95% CI: 0.703–0.863). Corresponding sensitivity and specificity values were 86.27% (95% CI: 73.7–94.3%) and 62.07% (95% CI: 48.4–74.5%). Stratified analysis of MPS patients by pain severity produced the following AUC values for trapezius SWV(mean) in MPS patients with mild, moderate, and severe pain: 0.578 (95% CI: 0.460–0.690), 0.899 (95% CI: 0.814–0.955), and 0.983 (95% CI: 0.914–0.999), respectively. CONCLUSIONS: Elasticity changes and increased stiffness in the trapezius occur in cervical MPS patients with moderate and severe pain. The SWV(mean) parameter reflecting trapezius muscle elasticity may be valuable for successful screening of cervical MPS, especially in patients with moderate and severe pain. |
format | Online Article Text |
id | pubmed-10423376 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-104233762023-08-14 Upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography Hao, Chang-Juan Kang, Xiao-Yan Kang, Chun-Song Li, Ting-Ting Huo, Jian-Zhong Xu, Qian Xiao, Wen-Li Zhao, Zhe-Xia Ji, Xing-Hua Zhang, Quan-Bin Quant Imaging Med Surg Original Article BACKGROUND: Myofascial pain syndrome (MPS) is a common cause of neck pain, which is a global public health problem. Because MPS does not present morphological changes within lesioned muscles, there are no imaging diagnostic criteria for this condition. In this study, we evaluate elasticity changes in upper trapezius muscles most frequently involved in cervical MPS using real-time ultrasound shear-wave elastography, and we examine their potential diagnostic value. METHODS: We consecutively enrolled 109 right posterior neck pain patients for this prospective study. Of these, 51 were diagnosed with MPS and 58 with non-MPS in the right side of their neck. Among MPS patients, 19 fell into the 1–3 range (mild pain) for pain scores on the visual analog scale (VAS), 25 fell into the 4–6 range (moderate pain), and 7 into the 7–10 range (severe pain). MPS was diagnosed by two independent clinicians using the diagnostic criteria proposed by Simons et al. Using real-time ultrasound shear-wave elastography, we measured right trapezius mean shear-wave velocity (SWV(mean)). The midpoint of the line between the foramen magnum and the end of the right acromion served as measuring point. Regions of interest were scaled to span 0–8.0 m/s. RESULTS: Trapezius SWV(mean) was significantly higher in MPS patients compared with non-MPS patients (P<0.001). Stratified analysis of MPS patients according to pain severity revealed similar trapezius SWV(mean) between mild pain and non-MPS patients (P=0.324), however SWV(mean) was higher in moderate and severe pain MPS patients compared with non-MPS patients (P<0.001). The area under the curve (AUC) value for upper trapezius SWV(mean) in MPS patients was 0.791 (95% CI: 0.703–0.863). Corresponding sensitivity and specificity values were 86.27% (95% CI: 73.7–94.3%) and 62.07% (95% CI: 48.4–74.5%). Stratified analysis of MPS patients by pain severity produced the following AUC values for trapezius SWV(mean) in MPS patients with mild, moderate, and severe pain: 0.578 (95% CI: 0.460–0.690), 0.899 (95% CI: 0.814–0.955), and 0.983 (95% CI: 0.914–0.999), respectively. CONCLUSIONS: Elasticity changes and increased stiffness in the trapezius occur in cervical MPS patients with moderate and severe pain. The SWV(mean) parameter reflecting trapezius muscle elasticity may be valuable for successful screening of cervical MPS, especially in patients with moderate and severe pain. AME Publishing Company 2023-06-20 2023-08-01 /pmc/articles/PMC10423376/ /pubmed/37581083 http://dx.doi.org/10.21037/qims-22-797 Text en 2023 Quantitative Imaging in Medicine and Surgery. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Hao, Chang-Juan Kang, Xiao-Yan Kang, Chun-Song Li, Ting-Ting Huo, Jian-Zhong Xu, Qian Xiao, Wen-Li Zhao, Zhe-Xia Ji, Xing-Hua Zhang, Quan-Bin Upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography |
title | Upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography |
title_full | Upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography |
title_fullStr | Upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography |
title_full_unstemmed | Upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography |
title_short | Upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography |
title_sort | upper trapezius muscle elasticity in cervical myofascial pain syndrome measured using real-time ultrasound shear-wave elastography |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423376/ https://www.ncbi.nlm.nih.gov/pubmed/37581083 http://dx.doi.org/10.21037/qims-22-797 |
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