Ultrasound echo intensity of cervical muscles in women with and without forward head posture

Cervical Multifidus Morphology and Quality is not Associated with Clinical Variables in Women with Fibromyalgia: An Observational Study

OBJECTIVE

Some studies have reported the presence of histological alterations such as myofibers disorganization and abnormalities in the number and shape of mitochondria in patients with fibromyalgia syndrome (FMS). Although Ultrasound imaging (US) is used to quantitatively characterize muscle tissues, US studies in patients with FMS are lacking. Therefore, we aimed to describe morphological and qualitative cervical multifidus (CM) muscle US features in women with FMS and to assess their correlation with clinical indicators.

DESIGN

Observational study.

SETTING

AFINSYFACRO Fibromyalgia Association (Madrid, Spain).

SUBJECTS

Forty-five women with FMS participated.

METHODS

Sociodemographic (e.g., age, height, weight, and BMI), clinical (e.g., pain -NPRS-, evolution time, related-disability -FIQ-) outcomes were collected. Images were acquired bilaterally at the cervical spine (C4-C5 level) and measured by an experienced examiner for assessing muscle morphology (e.g., cross-sectional area -CSA-, perimeter and shape) and quality (mean echo-intensity -EI- and intramuscular fatty infiltration -FI-). Side-to-side comparisons and a correlational analysis were conducted.

RESULTS

No significant side-to-side differences were found for morphology nor quality features (P > 0.05). None of the clinical indicators were associated with US characteristics (all, P > 0.05).

CONCLUSION

Our results showed no side-to-side differences for CM morphology and quality as assessed with US. No associations between CM muscle morphology nor quality with FIQ, PPT, NPRS nor evolution time were observed. Our preliminary data suggest that muscle morphology is not directly related to pain and related-disability in women with FMS.

Echo-intensity and fatty infiltration ultrasound imaging measurement of cervical multifidus and short rotators in healthy people: A reliability study

BACKGROUND

In addition to muscle morphology, ultrasound imaging (US) could be a potential tool to determine muscle quality assessing the echo-intensity and using offline software to quantify the percentage of intramuscular fatty infiltration.

OBJECTIVE

To investigate intra- and inter-rater image measurement reliability of morphological (i.e., cross-sectional area, perimeter) and echo intensity features (i.e., mean muscular echo intensity, fat echo intensity cut-offs, fatty infiltrates percentage estimation) of deep neck extensors in asymptomatic subjects.

METHODS

Brightness-mode images of the cervical spine at C4/C5 were acquired in 25 asymptomatic subjects (40%women, age: 24 years) by an experienced examiner. Cross-sectional area, perimeter and echo-intensity measures of cervical multifidus and short rotators were measured on two separate days (one-week apart) in a randomized order by two assessors. Intra-class correlation coefficients (ICC), standard error of measurement, minimal detectable change, and mean, absolute and percent errors were calculated.

RESULTS

Intra- (ICC_3,1 0.800-0.989) and inter- (ICC_3,2 0.841-0.948) examiner reliability of echo-intensity measures ranged from good to excellent. Women exhibited higher echo-intensity features than men. Intra-examiner reliability of morphological measures was excellent (ICC_3,1 0.917-0.974) for multifidus and good-excellent (ICC_3,1 0.868-0.987) for short rotators. Inter-examiner reliability of morphological measures also ranged from good to excellent (ICC_3,2 0.765-0.965). Men exhibited higher CSA and perimeter than women. No side-to-side differences were observed in any ultrasound measure.

CONCLUSION

This study found that intra- and inter-rater image analysis reliability of muscle morphology, mean echo intensity, and fatty infiltration quantification of cervical multifidus and short rotators at C4/C5 level was good-to-excellent in healthy subjects.