Quantitative Ultrasound Texture Feature Changes With Conservative Treatment of the Trapezius Muscle in Female Patients With Myofascial Pain Syndrome

Texture Analysis in Musculoskeletal Ultrasonography: A Systematic Review

Background: The objective of this systematic review was to summarize the findings of texture analyses of musculoskeletal ultrasound images and synthesize the information to facilitate the use of texture analysis on assessing skeletal muscle quality in various pathophysiological conditions. Methods: Medline, PubMed, Scopus, Web of Science, and Cochrane databases were searched from their inception until January 2025 using the PRISMA Diagnostic Test Accuracy and was registered at PROSPERO CRD42025636613. Information related to patients, interventions, ultrasound settings, texture analyses, muscles, and findings were extracted. The quality of evidence was evaluated using QUADAS-2. Results: A total of 38 studies using second-order and higher-order texture analysis met the criteria. The results indicated that no studies used an established reference standard (histopathology) to evaluate the accuracy of ultrasound texture analysis in diagnosing muscle quality. Alternative reference standards were compared, including various physiological, pathological, and pre-post intervention comparisons using over 200+ texture features of various muscles on diverse pathophysiological conditions. Conclusions: The findings of these included studies demonstrating that ultrasound texture analysis was able to discriminate changes in muscle quality using texture analysis between patients with pathological conditions and healthy conditions, including popular gray-level co-occurrence matrix (GLCM)-based contrast, correlation, energy, entropy, and homogeneity. Studies also demonstrated that texture analysis can discriminate muscle quality in various muscles under pathophysiological conditions although evidence is low because of bias in subject recruitment and lack of comparison with the established reference standard. This is the first systematic review of the use of texture analysis of musculoskeletal ultrasonography in assessing muscle quality in various muscles under diverse pathophysiological conditions.

Association between elasticity of tissue and pain pressure threshold in the tender points present in subjects with fibromyalgia: a cross-sectional study

Fibromyalgia (FM) is a multicomponent illness and despite its worldwide prevalence, a complete understanding of its aetiology and pathogenesis remains unclear. The goal of the study is to analyze the level of association between elastic properties of tissue measured by strain elastography (SEL) and pain pressure threshold (PPT) in the characteristic painful points described in patients suffering from FM. This was a cross-sectional, observational study. A sample comprised of 42 subjects with FM was recruited from a private care centre. The occiput, low cervical, trapezius, supraspinatus, paraspinous, lateral pectoral, second rib, lateral epicondyle, medial epicondyle, gluteus, greater trochanter, knee, and anterior tibial PPTs were bilaterally assessed using a standard pressure algometer and elastic properties of tissue were evaluated by SEL. Linear regression analysis showed significant associations between SEL and dominant trapezius PPT (β = 0.487, 95% CI [0.045, 0.930], p = 0.032) after adjustments for the age, body mass index, and menopause status (higher SEL and higher pain sensitivity). No significant associations between SEL and the other PPTs variables were found in women diagnosed with FM. The PPT of the dominant trapezius is associated with SEL measurements in subjects suffering from FM. More studies are required to fully explain the underlying mechanisms.

Do Psychological Factors Influence the Elastic Properties of Soft Tissue in Subjects with Fibromyalgia? A Cross-Sectional Observational Study

Nowadays, there is evidence related to the impact that psychological factors have on symptoms, specifically vegetative ones, and on the autonomic nervous system in patients with fibromyalgia (FM). However, there are no studies to correlate the level of association between psychological factors and the elastic properties of tissue in the FM population. Elastic properties of soft tissue reflect age- and disease-related changes in the mechanical functions of soft tissue, and mechanical failure has a profound impact on morbidity and mortality. The study has a cross-sectional observational design with 42 participants recruited from a private clinic and rehabilitation service. The Pain Catastrophizing Scale, Tampa Kinesiophobia Scale and Self-Efficacy Scale were used to assess psychological factors. The elastic properties of the tissue in the characteristic painful points, which patients suffering from FM described, were assessed by strain elastography. A low and significant level of association was found between pain catastrophising scale (PCS) and the non-dominant lateral epicondyle (r = -0.318; p = 0.045). Kinesiophobia was found to be related to the dominant lateral epicondyle (r = 0.403; p = 0.010), the non-dominant knee (r = -0.34; p = 0.027) and the dominant forearm (r = 0.360; p = 0.010). Self-Efficacy showed a low level of association with the non-dominant supraspinatus (r = -0.338; p = 0.033) and the non-dominant medial epicondyle (r = -0.326; p = 0.040). Psychological factors and the elastic properties of tissue seem to be associated in patients suffering from FM. The most profound association between psychological factors and non-dominant parts of the body could be related to neglect and non-use of those parts of the body.