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A. Fruend1, S. Kolbe2, H. Koerperich3, U.-P.D.m.W. Burchert4, P.M.J. Gummert5
1Heart and Diabetescentre Northrhine Westphalia, Bad Oeynhausen, Germany, Physiotherapy, Bad Oeynhausen, Germany, 2Heart and Diabetescentre Northrhine Westphalia, Institute Radiology, Nuklearmedicine und MRI, Bad Oeynhausen, Germany, 3Heart and Diabetescentre Northrhine Westphalia, Institute Radiology, Nuklearmedicine und MRI, Bad Oeynhausen, Germany, 4Heart and Diabetescentre Northrhine Westphalia, Institute for Radiology, Nuclear Medicine and Molecular Imaging, Bad Oeynhausen, Germany, 5Heart and Diabetescentre Northrhine Westphalia, Director Clinic for Thoracic and Cardiovascular Surgery, Bad Oeynhausen, Germany
Background: Palpable nodules in skeletal muscles are frequently linked to myogelosis (=myofascial-trigger-point-complexes, MTrPs) leading to chronic pain and which are associated with local alterations in morphology and metabolism. The current identification by means of palpation by physical therapists often leads to non-conclusive results.
Purpose: To examine degeneration processes of the skeletal muscle tissue in the vicinity of MTrPs by using magnetic resonance imaging (MRI) fat quantification (FQ) and relaxation time measurements.
Design: Cross-sectional study.
Setting: University hospital with quaternary care.
Design: Cross-sectional study.
Setting: University hospital with quaternary care.
Methods: Main outcome measures: MRI was performed using T1-weighted imaging for fat quantification and T1/T2-mapping in breath-hold-technique for assessment of relaxation times. Fat fraction and relaxation times were calculated in the M. iliocostalis and M. longissimus thoracis at the level of L5/S1.
Results: 18 participants with at least one palpated MTrPs mean age was 49±8yrs (32-60yrs, median=49yrs, 10 females). In the same period of time, five controls were included; mean age of 28±12yrs (19-49yrs, median=25yrs, 3 females). All participants were asked about the frequency of their physical leisure activity and the possible reasons for the ailment using a questionnaire. Three MTrPs patients (17%) were not physically active (e.g. jogging, bike riding, fitness training and swimming), eleven MTrPs patients (61%) were active 1-3 times/week and four MTrPs patients (22%) more than 4 times/week. Forty percent of the controls were physically active 1-3 times/week and 60% more than 4 times/week. The MTrPs patients’ subjective rating regarding the potential trigger for the onset of disease is shown in Figure 4. Main reasons for initiation were of unknown origin (29%), sedentary work (29%) and particular physical strain (19%).
All MRI measurements were completed successfully by the study participants.
All MRI measurements were completed successfully by the study participants.
Conclusion(s): In the vicinity of palpable nodules muscle atrophy was identified applying magnetic resonance imaging techniques. A statistically significant increase of the fat fraction and a statistically significant reduction of T1-relaxation times were observed in the MTrPs patients compared with the control-group. As opposed to biopsy, magnetic resonance imaging allows a non-invasive examination of degenerative processes and is suitable to perform follow-up studies.
Implications: There should be more studies according myogelosis, often used vocabular but not really defined.
Funding, acknowledgements: This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors.
Keywords: Myofascial trigger point complex, magnetic resonance imaging, fat quantification
Topic: Musculoskeletal
Did this work require ethics approval? No
Institution: Heart- and Diabetescentre Northrhine-Westphalia, Bad Oeynhausen Germany
Committee: Ruhruniversity Bochum
Reason: No ethic problems
All authors, affiliations and abstracts have been published as submitted.
