Localization of trigger points of female myofascial pelvic pain guided by tenderness with transvaginal ultrasound probe
10.3760/cma.j.cn131148-20230419-00220
- VernacularTitle:经阴道超声探头触痛引导的女性盆腔肌筋膜疼痛扳机点的定位研究
- Author:
Lichen WANG
1
;
Zhenwei XIE
;
Hongyun ZHANG
;
Qingguo ZOU
;
Minyan WANG
;
Yutian HAN
;
Tian DING
;
Shuang ZHANG
;
Qunyan PAN
;
Jiang ZHU
Author Information
1. 浙江大学医学院附属妇产科医院超声科 浙江省妇产疾病临床医学研究中心，杭州 310006
- Keywords:
Ultrasonography;
Myofascial pain;
Pelvic floor muscle;
Trigger point
- From:
Chinese Journal of Ultrasonography
2023;32(10):900-906
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To develop a simple, practical and repeatable ultrasound method to locate the muscle at the trigger point of female myofascial pelvic pain(MPP), which can provide imaging reference for clinical precision treatment.Methods:A total of 113 patients with suspected MPP who came to the Women′s Hospital School of Medicine Zhejiang University from September 1, 2021 to April 20, 2023 were prospectively selected. The gynecologist performed internal examination with index finger on some pelvic floor muscles (puborectalis, pubococcygeus, iliococcygeus, coccygeus) and pelvic wall muscles (piriformis and obturator internus) respectively, searched for the muscles where the pain trigger point was located, and scored the pain by referring to visual analogue scale (VAS) and numerical rating scale (NRS), and then referred the patients to the ultrasound department. The ultrasound doctor used transvaginal ultrasound to display the above muscle groups in real time for observation and appropriate pressure. The muscle where the painful trigger point was located was found through tenderness and the pain score was performed. The two scores were compared for consistency and difference analysis.Results:The trigger point was clear and of good reproducibility. For the location and score of pain trigger points located in bilateral puborectalis, pubococcygeus and coccygeus, there was a strong consistency between the tenderness guided by vaginal ultrasound probe and clinical palpation (the consistency rate was ≥70%), and there was no significant difference in the pain scores of the trigger points located in the puborectalis muscle and coccygeal muscle between the two methods ( P>0.05), and there was statistically significant difference in the pain scores of the trigger points located in the other pelvic floor and pelvic wall muscles (all P<0.05). At the same time, ultrasonic examination made up for the deficiency of clinical palpation in the evaluation of piriformis muscle. Conclusions:The present method for finding the trigger point of MPP guided by the ultrasound probe is a new non-invasive, safe, simple and practical imaging method, which can provide a new imaging reference for the clinical diagnosis of MPP and the formulation of treatment strategies.
