Quantitative Ultrasound Assessment of Myofascial Pain Syndrome Affecting the Trapezius: A Reliability Study

J Ultrasound Med. 2017 Dec;36(12):2559-2568. doi: 10.1002/jum.14308. Epub 2017 Jul 3.


Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: head and neck; musculoskeletal ultrasound; myofascial pain syndrome; point-of-care; quantitative; reliability; ultrasound.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myofascial Pain Syndromes / diagnostic imaging*
  • Myofascial Pain Syndromes / physiopathology*
  • Reproducibility of Results
  • Superficial Back Muscles / diagnostic imaging*
  • Superficial Back Muscles / physiopathology*
  • Ultrasonography / methods*
  • Young Adult