Assessment of Myofascial Trigger Points via Imaging: A Systematic Review.

This study systematically reviewed the published literature on the objective characterization of myofascial pain syndrome and myofascial trigger points using imaging methods. PubMed, Embase, Ovid and the Cochrane Library databases were utilized, while citation searching was conducted in Scopus. Citations were restricted to those published in English and in peer-reviewed journals between 2000–2021. Out of 1,762 abstracts screened, 69 articles underwent full-text review and 33 were included. Imaging data assessing myofascial trigger points (MTrPs) or myofascial pain syndrome (MPS) were extracted and important qualitative and quantitative information on general study methodologies, study populations, sample sizes, and MTrP/MPS evaluation were tabulated. Methodological quality of eligible studies was assessed based on the QUADAS (Quality Assessment of Diagnostic Accuracy Studies) criteria. Biomechanical properties and blood flow of active and latent MTrPs assessed via imaging were found to be quantifiably distinct from those of healthy tissue. While these studies show promise, more studies are needed. Future studies should focus on assessing diagnostic test accuracy and testing the reproducibility of results to establish the best performing methods. Increasing methodological consistency would further motivate implementing imaging methods in larger clinical studies. Considering the evidence on efficacy, cost, ease of use and time constraints, US-based methods are currently the imaging modalities of choice for MPS/MTrP assessment.

本研究系统回顾了已发表的关于使用影像学方法对肌筋膜疼痛综合征和肌筋膜触发点进行客观描述的文献。利用了PubMed、Embase、Ovid和Cochrane图书馆数据库，并在Scopus中进行了引文检索。引文仅限于2000年至2021年期间在英文且经同行评审的期刊上发表的文献。在筛选的1762篇摘要中，69篇文章进行了全文审查，其中33篇被纳入。提取了评估肌筋膜触发点（MTrPs）或肌筋膜疼痛综合征（MPS）的影像学数据，并将有关一般研究方法、研究人群、样本量以及MTrP/MPS评估的重要定性和定量信息制成表格。根据QUADAS（诊断准确性研究质量评估）标准对符合条件的研究的方法学质量进行了评估。通过影像学评估发现，活动和潜在的MTrPs的生物力学特性和血流在数量上与健康组织有明显差异。虽然这些研究有希望，但还需要更多的研究。未来的研究应侧重于评估诊断测试的准确性以及测试结果的可重复性，以确定最佳的方法。提高方法学的一致性将进一步推动在更大规模的临床研究中应用影像学方法。考虑到有效性、成本、易用性和时间限制等方面的证据，基于超声的方法目前是MPS/MTrP评估的首选影像学方式。