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Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response

The literature has hypothesized that a trigger point (TrP) area consists of a hyperperfused contracture knot with smaller hypoperfused TrPs within the contracture knot. By contrast, the only published ultrasound image of a TrP has it labeled hypoechoic (i.e., hyperperfused) with no commentary regard...

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Autores principales: Ball, Andrew, Perreault, Thomas, Fernández-de-las-Peñas, César, Agnone, Michael, Spennato, Jordan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871029/
https://www.ncbi.nlm.nih.gov/pubmed/35204411
http://dx.doi.org/10.3390/diagnostics12020321
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author Ball, Andrew
Perreault, Thomas
Fernández-de-las-Peñas, César
Agnone, Michael
Spennato, Jordan
author_facet Ball, Andrew
Perreault, Thomas
Fernández-de-las-Peñas, César
Agnone, Michael
Spennato, Jordan
author_sort Ball, Andrew
collection PubMed
description The literature has hypothesized that a trigger point (TrP) area consists of a hyperperfused contracture knot with smaller hypoperfused TrPs within the contracture knot. By contrast, the only published ultrasound image of a TrP has it labeled hypoechoic (i.e., hyperperfused) with no commentary regarding smaller speckles of hypoperfusion within. Furthermore, the lack of clarity in objective definition of the terms associated with the TrP (namely, the palpable “contracture knot” and smaller nonpalpable “trigger point”) has led to unnecessary communication difficulties between and among clinicians and researchers. In this case series of three muscles across two patients, by using high-definition musculoskeletal ultrasound imaging technology, we present what we believe to be the first reliable capture of palpable hypoechoic (e.g., hypoperfused) contracture knots (previously mislabeled as a hypoechoic TrP), and a visual support of the multiple loci hypothesis first proposed by Hong and Simons—the first reliable confirmation of the hyperechoic (i.e., hypoperfused) TrP within. Initially proposed by a histological study and supported by microdialysis study, this case series lends further support for the multiple loci hypothesis through visual confirmation of palpable hypoechoic contracture knots, with smaller hypoechoic TrPs “speckles” within.
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spelling pubmed-88710292022-02-25 Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response Ball, Andrew Perreault, Thomas Fernández-de-las-Peñas, César Agnone, Michael Spennato, Jordan Diagnostics (Basel) Case Report The literature has hypothesized that a trigger point (TrP) area consists of a hyperperfused contracture knot with smaller hypoperfused TrPs within the contracture knot. By contrast, the only published ultrasound image of a TrP has it labeled hypoechoic (i.e., hyperperfused) with no commentary regarding smaller speckles of hypoperfusion within. Furthermore, the lack of clarity in objective definition of the terms associated with the TrP (namely, the palpable “contracture knot” and smaller nonpalpable “trigger point”) has led to unnecessary communication difficulties between and among clinicians and researchers. In this case series of three muscles across two patients, by using high-definition musculoskeletal ultrasound imaging technology, we present what we believe to be the first reliable capture of palpable hypoechoic (e.g., hypoperfused) contracture knots (previously mislabeled as a hypoechoic TrP), and a visual support of the multiple loci hypothesis first proposed by Hong and Simons—the first reliable confirmation of the hyperechoic (i.e., hypoperfused) TrP within. Initially proposed by a histological study and supported by microdialysis study, this case series lends further support for the multiple loci hypothesis through visual confirmation of palpable hypoechoic contracture knots, with smaller hypoechoic TrPs “speckles” within. MDPI 2022-01-27 /pmc/articles/PMC8871029/ /pubmed/35204411 http://dx.doi.org/10.3390/diagnostics12020321 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Ball, Andrew
Perreault, Thomas
Fernández-de-las-Peñas, César
Agnone, Michael
Spennato, Jordan
Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response
title Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response
title_full Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response
title_fullStr Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response
title_full_unstemmed Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response
title_short Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response
title_sort ultrasound confirmation of the multiple loci hypothesis of the myofascial trigger point and the diagnostic importance of specificity in the elicitation of the local twitch response
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8871029/
https://www.ncbi.nlm.nih.gov/pubmed/35204411
http://dx.doi.org/10.3390/diagnostics12020321
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