Documentação da síndrome dolorosa miofascial por imagem infravermelha
DOI:
https://doi.org/10.11606/issn.2317-0190.v14i1a102775Palavras-chave:
Síndromes da Dor Miofascial, Diagnóstico por Imagem, TermografiaResumo
Os pontos-gatilho (PG) miofasciais são encontrados em muitas lesões cervicais com hiperextensão/hiperflexão, discopatias e lesões/ desordens por esforço repetitivo. Desde o extremo da simulação, ao frustrante dilema na investigação objetiva da dor crônica, uma das indicações básicas e melhores da comprovação por imagem infravermelha (IR) é a de documentar afecções de tecidos moles, particularmente nos casos em que não são demonstradas por exames radiológicos, eletroneuromiográficos ou laboratoriais. Os autores revisaram a literatura sobre imagem IR na documentação da síndrome dolorosa miofascial. O exame por IR é complemento essencial do diagnóstico clínico mostrando objetivamente PG na forma de pontos aquecidos hiperradiantes. Estas áreas hiperradiantes, correspondem a PG dolorosos anotados no exame clínico. Estes são corroborados pela sensibilidade local e confirmação da dor pelos pacientes. As áreas dolorosas referidas se apresentam termicamente assimétricas com o lado oposto. Os PG latentes, não objetivamente queixados pelos pacientes durante o exame IR, também são descritos sob a forma de pontos hiperradiantes. A presença destes PG latentes pode ser confirmada pela algometria de pressão nestas áreas. Após infiltração/agulhamento há alteração do perfil térmico cutâneo demonstrando resposta neurovegetativa simpática imediata. As alterações de imagem IR se constituem, assim, em importante recurso objetivo na demonstração de PG miofasciais, correlatos com as queixas objetivas do paciente. A documentação dos PG por imagem IR é útil no direcionamento para causa da dor, orientação do tratamento adequado, assim como avaliação de sua resposta.
Downloads
Referências
Teixeira MJ, Barros Filho T, Lin TY, Hamani C, Teixeira WGJ. Cervicalgias. Rev Med (Sao Paulo). 2001;80(Pt2):307-16.
Teixeira MJ, Barros Filho T, Lin TY, Hamani C, Teixeira WGJ. Cervicalgias. In: Teixeira MJ. Dor: contexto interdisciplinar. Curitiba: Maio; 2003. p.453-62.
Lin TY, Kaziyama HHS, Teixeira MJ. Síndrome dolorosa miofascial. In: Teixeira MJ. Dor: contexto interdisciplinar. Curitiba: Maio; 2003. p.271-88.
Travel JG, Simons DG. Myofascial pain and dysfunction: the trigger point manual, the upper extremities. Baltimore: Willians & Wilkins; 1992.
Wolfe F, Simons DG, Fricton J, Bennett RM, Goldenberg DL, Gerwin R, et al. The fibromyalgia and myofascial pain syndromes: a preliminary study of tender points and trigger points in persons with fibromyalgia, myofascial pain syndrome and no disease. J Rheumatol. 1992;19(6):944-51.
Nice DA, Riddle DL, Lamb RL, Mayhew TP, Rucker K. Intertester reliability of judgments of the presence of trigger points in patients with low back pain. Arch Phys Med Rehabil. 1992;73(10):893-8.
Njoo KH, Van der Does E. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: a prospective study in non-specific low back pain patients and controls in general practice. Pain. 1994;58(3):317-23.
Gerwin RD, Shannon S, Hong CZ, Hubbard D, Gevirtz R. Interrater reliability in myofascial trigger point examination. Pain. 1997;69(1-2):65-73.
Bonica JJ. Myofascial syndromes with trigger mechanism. In: Bonica JJ, editor. The management of pain. Philadelphia: Lea & Febiger; 1953. p.1150-1.
Fishbain DA, Goldberg M, Meagher BR, Steele R, Rosomoff H. Male and female chronic pain patients categorized by DSM-III psychiatric diagnostic criteria. Pain. 1986;26(2):181-97.
Bonica JJ. Management of myofascial pain syndromes in general practice. J Am Med Assoc. 1957;164(7):732-8.
Hobbins W. Differential diagnosis of pain using thermography. In: Recent Advances in Biomedical Thermology. New York: Plenum Press; 1984. p.503-6.
Fischer AA. Advances in documentation of pain and soft tissue pathology. J Fam Med. 1983; 24-31.
Fischer AA. The present status of neuromuscular thermography. In: Clinical Proceeding of the Academy of Neuromuscular Thermography. Dallas: McGray-Hill Book: 1985. p.26-33.
Green J, Noran WH, Coyle MD, et al. Infrared electronic thermography: a non-invasive diagnostic neuroimaging tool. Contemp Orthop. 1985;11:39-47.
Diakow PR.Thermographic imaging of myofascial trigger points. J Manipulative Physiol Ther. 1988;11(2):114-7.
Simons DG. Myofascial pain syndromes: where are we? Where are we going? Arch Phys Med Rehabil. 1988;69(3 Pt 1):207-12.
Wolf TD. Thermographic imaging of myofascial trigger points. J Manipulative Physiol Ther. 1989;12(1):63-4.
Christiansen J, Gerrow G. Thermography. Baltimore: Williams & Wilkins; 1990.
Janssens LA. Trigger point therapy. Probl Vet Med. 1992;4(1):117-24.
Balbinot LF, Vieira LR. Avaliaçao objetiva da síndrome dolorosa miofascial: uso da termografia antes e após tratamento associando mesoterapia a bloqueio anestésico. Acta Fisiatr. 2005;12(3):115-7. Doi: https://doi.org/10.11606/issn.2317-0190.v12i3a102534
Brioschi ML, Portela PC, Colman D, Laskawski S, Santos LC. Infrared thermal imaging in patients with chronic pain in upper limbs. J Korean Med Thermol. 2002;2(1):73.
Fischer AA, Chang CH. Temperature and pressure threshold measurements in trigger points. Thermology. 1986;1(4):212-5.
Fischer AA. Documentation of myofascial trigger points. Arch Phys Med Rehabil. 1988;69(4):286-91.
Kruse RA Jr, Christiansen JA. Thermographic imaging of myofascial trigger points: a follow-up study. Arch Phys Med Rehabil. 1992;73(9):819-23.
Diakow PR. Differentiation of active and latent trigger points by thermography. J Manipulative Physiol Ther 15(7):439-441, 1992.
Fischer AA. Diagnosis and management of chronic pain in physical medicine and rehabilitation. In: Ruskin AP. Current Therapy in Physiatry. Philadelphia: Saunders; 1984. p.123-54.
Feldman F, Nickoloff EL. Normal thermographic standards for the cervical spine and upper extremities. Skeletal Radiol. 1984;12(4):235-49.
Uematsu S, Jankel WR, Edwin DH, Kim W, Kozikowski J, Rosenbaum A, et al. Quantification of thermal asymmetry. Part 2: Application in low-back pain and sciatica. J Neurosurg. 1988;69(4):556-61.
Thomas D, Cullum D, Siahamis G, Langlois S. Infrared thermographic imaging, magnetic resonance imaging, CT scan and myelography in low back pain. Br J Rheumatol. 1990;29(4):268-73.
Kovac C, Krapf M, Ettlin T, Mennet P, Stratz T, Muller W. Methods for detection of changes in muscle tonus. Z Rheumatol. 1994;53(1):26-36.
Korr IM, Thomas PE, Wright HM. Clinical significance of facilitated state. JAOA. 1955;54:277-82.
Gerwin RD. A study of 96 subjects examined both for fibromyalgia and myofascial pain (Abstract). J Musculoske Pain 3(suppl 1):121, 1995.
Scudds RA, Heck C, Delaney G. A comparison of referred pain, resting skin temperature and other signs in fibromyalgia (FM) and myofascial pain syndrome (MPS). J Musculoske Pain. 1995; 3(S1):97.
Biasi G, Fioravanti A, Franci A, Marcolongo R. The role computerized telethermography in the diagnosis of fibromyalgia syndrome. Minerva Med. 1994;85(9):451-4.
Hakguder A, Birtane M, Gurcan S, Kokino S, Turan FN. Efficacy of low level laser therapy in myofascial pain syndrome: an algometric and thermographic evaluation. Lasers Surg Med. 2003;33(5):339-43.
Brioschi ML, Colman D, Kosikov A. Terapia de pontos-gatilhos guiada por termografia infravermelha. Rev Soc Bras Est Dor. 2004;5(3):9.
Menachem A, Kaplan O, Dekel S. Levator scapulae syndrome: an anatomic-clinical study. Bull Hosp Jt Dis. 1993;53(1):21-4.
Sucher BM. Thoracic outlet syndrome - a myofascial variant: Part 1. Pathology and diagnosis. J Am Osteopath Assoc. 1990;90(8):686-96,703-4.
Jaeger B, Reeves JL. Quantification of changes in myofascial trigger point sensitivity with the pressure algometer following passive stretch. Pain. 1986;27(2):203-10.
Swerdlow B, Dieter JN. An evaluation of the sensitivity and specificity of medical thermography for the documentation of myofascial trigger points. Pain. 1992;48(2):205-13.
Radhakrishna M, Burnham R. Infrared skin temperature measurement cannot be used to detect myofascial tender spots. Arch Phys Med Rehabil. 2001;82(7):902-5.
Brioschi ML, Colman D, Kosikov A. Avaliaçao dos sintomas neuromusculares em pacientes com disfunçao temporomandibular por meio de termografia infravermelha. Rev Soc Bras Est Dor. 2004;5(3):37.
Pogrel MA, McNeill C, Kim JM. The assessment of trapezius muscle symptoms of patients with temporomandibular disorders by the use of liquid crystal thermography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82(2):145-51.
Brioschi ML, Colman D, Kosikov A. Imagem termográfica na avaliaçao da cefaléia. Rev Soc Bras Est Dor. 2004;5(3):48.
Wang C, Long X, Zhu X. A study on the clinical curative effect by acupuncture for myofascial pain dysfunction syndrome. Zhonghua Kou Qiang Yi Xue Za Zhi. 1998;33(5):273-5.
Brioschi ML, Macedo JF, Macedo RAC. Skin thermometry: new concepts J Vasc Br. 2003;2(2):151-60.
Chen JT, Chen SM, Kuan TS, Chung KC, Hong CZ. Phentolamine effect on the spontaneous electrical activity of active loci in a myofascial trigger spot of rabbit skeletal muscle. 1: Arch Phys Med Rehabil. 1998;79(7):790-4.
Lewis C, Gervirtz R, Hubbard D. Needle trigger point and surface frontal EMG measurements of psychophysiological responses in tension-type headache patients. Biofeedback Self Regul. 1994;19(3):274-5.
McNulty WH, Gevirtz RN, Hubbard DR, Berkoff GM. Needle electromyographic evaluation of trigger point response to a psychological stressor. Psychophysiology. 1994;31(3):313-6.
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2007 Acta Fisiátrica
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
