MR imaging of muscle and tender points in fibromyalgia

Abstract

Fibromyalgia is a syndrome manifested by chronic, diffuse musculoskeletal aching and soreness, palpable muscle tender points, and other symptoms. Standardized clinical diagnostic criteria have recently been developed. Skeletal muscle has been postulated as the end organ in this disease. Biochemical, histologic, electromyographic, and conventional radiographic studies have demonstrated no definitive abnormality. This study sought to establish whether magnetic resonance (MR) imaging could demonstrate any abnormality in these patients. Eighteen patients were entered in the study, 14 of whom were able to complete their examinations. T1-weighted, T2-weighted, gradient-echo, and STIR (short-tau inversion-recovery) sequences were performed in all patients, with selected patients examined with T1-weighted, gadopentetate dimeglumine-enhanced sequences. The trapezius and suboccipital regions were imaged in patients who, clinically, had active fibromyalgia. No abnormalities could be detected. The authors conclude that the conventional MR imaging used in this study was unable to depict any primary skeletal muscle abnormality in fibromyalgia.

Muscle Physiology and Pathophysiology: Magnetic Resonance Imaging Evaluation

“…In such instances, such as fibromyalgia, even the negative finding is a clue that whatever the pathology is, it does not cause substantial muscle deterioration. 71 Furthermore, the negative MRI finding in such cases supports other data suggesting that muscle is not primarily effected.…”

“…Incorporation of these physiologic tools in patient studies has also redefined scientific approaches to probing muscle pathophysiology. [67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85] This article details these physiologic arenas, where much recent progress is owed to MR imaging of skeletal muscle.…”

Der Einsatz der Magnetresonanztomographie der Muskulatur bei der Diagnose neuromuskulärer Erkrankungen

“…Hierbei handelt es sich nicht um eine Muskelerkrankung im engeren Sinne [28], sondern vielmehr um eine Schmerzperzeptionsstörung [19,24]. Da selbst in einer spezialisierten neuromuskulären Sprechstunde der Anteil der Myopathien bei Patienten mit Hauptbeschwerde Muskelschmerz nur ca.…”

The Use of Botulinum Toxins in the Management of Pain and Headache

“…The localized spasm induces release of nociceptive and inflammatory mediators that produces a positive feedback process leading to focal ischemia (depletion of ATP), lactic acidosis, and eventual fibrosis. However, pathological and histological analyses do not support this theory 57 …”

“…However, pathological and histological analyses do not support this theory. 57 The dysfunctional muscle spindle and the irritable motor endplate models grew out of different interpretations of electromyographic EMG evaluations of trigger points. Durette et al studied 21 patients with MPS and found no evidence of spontaneous fibrillation or positive sharp wave potentials.…”