Fatty degeneration of multifidus muscle in patients with chronic low back pain and in asymptomatic volunteers: quantification with chemical shift magnetic resonance imaging.

By London Spine
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Fatty degeneration of multifidus muscle in patients with chronic low back pain and in asymptomatic volunteers: quantification with chemical shift magnetic resonance imaging.

Skeletal Radiol. 2012 Dec 20;

Authors: Yanik B, Keyik B, Conkbayir I

Abstract
OBJECTIVE: To evaluate and compare the fatty degeneration of multifidus muscles by chemical shift magnetic resonance imaging (MRI) in patients with chronic low back pain and in asymptomatic volunteers. MATERIALS AND METHODS: Sixty-five patients with lumbar disc pathology were selected prospectively for this study. The control group consisted of 25 asymptomatic volunteers. The patients were grouped according to the fatty degeneration of multifidus muscles by a semiquantitative method (grade 0-4) on axial T2 weighted imaging. Chemical shift MRI was performed in the axial plane using a double-echo fast low-angle shot (FLASH) sequence. Fatty degeneration was calculated through signal intensity suppression rate (SISR) and signal intensity index (SII). RESULTS: The semiquantitative grading of fatty degeneration of the multifidus muscle was 0 in 25 of 65 patients (patient group 0), 1 in 20 patients (patient group 1), 2 in 20 patients (patient group 2). Neither grade 3 nor grade 4 were detected in patient groups. For the control group, patient group 0, patient group 1, and patient group 2, median SISR values were 5.00, -9.00, -17.50, and -22.50 %, respectively. SII median values were -4.20 % for the control group, 7.00 % for patient group 0, 12.50 % for patient group 1, and 19.50 % for patient group 2. SISR values in the multifidus muscle calculated for the patient groups were significantly lower than those calculated for the control group. SII values in patients groups were significantly higher than in the control group. CONCLUSIONS: Chemical shift MRI may be a useful method to quantitatively evaluate the fatty degeneration in multifidus muscle in patients with low back pain.

PMID: 23263412 [PubMed – as supplied by publisher]

The reliability of rehabilitative ultrasound imaging in the measurement of infraspinatus muscle function in the symptomatic and asymptomatic shoulders of patients with unilateral shoulder impingement syndrome.

By London Spine
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The reliability of rehabilitative ultrasound imaging in the measurement of infraspinatus muscle function in the symptomatic and asymptomatic shoulders of patients with unilateral shoulder impingement syndrome.

Int J Sports Phys Ther. 2015 Apr;10(2):128-35

Authors: Koppenhaver S, Harris D, Harris A, O’Connor E, Dummar M, Croy T, Walker M, Flynn T

Abstract
BACKGROUND: Rehabilitative ultrasound Imaging (RUSI) is increasingly used in the management of musculoskeletal conditions as it provides an objective measure of muscle function while being less invasive than needle electromyography. While research has documented the ability to reliably measure trunk muscles in patients with back pain, no study to date has used RUSI to quantify infraspinatus muscle function in patients with shoulder impingement syndrome (SIS).
HYPOTHESIS/PURPOSE: The purpose of this study was to examine the intra-rater and inter-rater reliability of measuring infraspinatus muscle thickness with RUSI and to compare such measures during resting versus contracted muscle states and in the symptomatic versus asymptomatic shoulders in patients with SIS.
STUDY DESIGN: Cross-sectional, measurement study.
METHODS: Fifty-two participants with unilateral SIS underwent a standard baseline examination to include RUSI of the infraspinatus muscle bilaterally. Images were acquired at rest and during a submaximal isometric contraction, by two novice examiners. The isometric contraction was elicited by having prone participants externally rotate their shoulder from a position of 90° abduction into a dynamometer and hold a static force of 20 mmHg (approximately 20-30% maximal voluntary contraction). Images were captured using a standardized placement of the transducer placed just inferior to the spine of the scapula along the medial scapular border and measured off-line using Image J software (V1.38t, National Institutes of Health, Bethesda, Maryland).
RESULTS: Estimates (ICCs) for thickness measurements ranged between 0.96 and 0.98 for intra-rater reliability and between 0.87 and 0.92 for inter-rater reliability. Reliability was substantially lower (ICC = 0.43 to 0.79) for calculations of percent thickness change. The infraspinatus muscle was significantly thicker when contracted (19.1mm) than during rest (16.2mm) in both shoulders (p < 0.001). There was also a statistically significant interaction between contraction state and shoulder (p = 0.026), indicating that the change in thickness that occurred during contraction was significantly smaller in the symptomatic shoulder than in the asymptomatic shoulder.
CONCLUSION: RUSI measurements of infraspinatus muscle thickness appear to be highly reliable, both within the same examiner and between different examiners, in patients with SIS. Moreover, such measurements were different in rested and contracted states of the infraspinatus, as well as, between the symptomatic and asymptomatic shoulders of patients with unilateral SIS.
LEVEL OF EVIDENCE: Level 2.

PMID: 25883861 [PubMed]