title: Referred pain patterns of the third and fourth dorsal interosseous muscles.
abstract: BACKGROUND
  Myofascial pain (MP) is a common disorder that can involve any skeletal muscle in the human body. There are no published reports of the referred pain patterns of the third and fourth dorsal interosseous muscles.
  
  
  OBJECTIVE
  To investigate the referred pain patterns of the third and fourth dorsal interosseous muscles.
  
  
  METHODS
  Prospective evaluation.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Twenty healthy adults participated in the study. Needle placement and injection of 0.2 mL 6% hypertonic saline solution into the midpoint of the interosseous muscles were performed under ultrasonographic (US) guidance. After the injections, the participants were instructed to wait until they felt the most pain and then draw a pain diagram. This drawing was transferred to the computer for analysis.
  
  
  RESULTS
  The referred pain distributions for the third dorsal interosseous muscle were as follows: the interdigital space of the third and fourth fingers, 80%; the distal phalanx of the third and fourth fingers, 45%; and the ulnar side of the palm, 55%. Three and 6 participants reported pain on the volar side of the wrist and in the fifth finger, respectively. The referred pain distributions for the fourth dorsal interosseous muscle were as follows: the interdigital space of the fourth and fifth fingers, 80%; the hypothenar area, 65%; and the distal phalanx of the fourth and fifth fingers, 60%. Seven and 3 participants also reported pain on the ulnar side of the wrist and the ulnar side of the forearm, respectively.
  
  
  CONCLUSIONS
  This study is limited by its small sample size.
  
  
  CONCLUSIONS
  Referred pain patterns of the third and fourth interosseous muscles resemble the pain experienced in C7 or C8 radiculopathies or the ulnar neuropathy. Thus, identification of the third and fourth interosseous muscle trigger point should be considered when patients experience pain on the ulnar aspect of the hand and wrist.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Republic of Korea.
authors.forename: Tae Woong
authors.initials: TW
authors.lastname: Choi
authors.forename: Hyeun Jun
authors.initials: HJ
authors.lastname: Park
authors.forename: Ah Ry
authors.initials: AR
authors.lastname: Lee
authors.forename: Yoon Kyoo
authors.initials: YK
authors.lastname: Kang
mesh_terms: D000328:Adult; D005260:Female; D005385:Fingers / Q000503:physiopathology; D005542:Forearm / Q000503:physiopathology; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010146:Pain / Q000139:chemically induced; D010147:Pain Measurement; D053591:Referred Pain / Q000503:physiopathology*; D011446:Prospective Studies; D012462:Saline Solution, Hypertonic; D055815:Young Adult
chemical_list: D012462:Saline Solution, Hypertonic