title: Quantification of Myofascial Taut Bands.
abstract: OBJECTIVE
  To assess the correlation of clinician-identified myofascial taut bands with their presence and characteristics on magnetic resonance elastography (MRE) imaging.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  A magnetic resonance imaging (MRI) research laboratory.
  
  
  METHODS
  A convenience sample of adults (N=65; 45 women, 20 men) identified by skilled musculoskeletal physicians as having upper trapezius myofascial pain-associated taut bands.
  
  
  METHODS
  Subjects had their taut bands outlined and were positioned within a 1.5T MRI machine. Shear waves were induced with a pneumatic transducer located over the belly of the involved muscle. Wave propagation was visualized with MRE images across a vibration cycle. Imaging data were assessed independently by 2 skilled MRE interpreters.
  
  
  METHODS
  The primary outcome measure was the determination of the intra- and interrater reliabilities of MRE taut band identification and their correlation with clinician identification of band presence. Secondary outcomes consisted of the elucidation of the physical characteristics of taut bands and their surrounding muscle tissue.
  
  
  RESULTS
  MRE intra- and interrater reliability was excellent, with kappa coefficients and 95% confidence intervals (CIs) of .86 (.68-1.00) and .93 (.79-1.00), respectively. Stiffness in MRE-identified taut bands was elevated at a mean ± SD of 11.5±2.4 kPa and fell to 5.8±0.9 kPa in surrounding muscle tissue (P<.001); muscular tone in trapezius muscles without a taut band was relatively uniform at 6.6±2.1 kPa. Agreement between the physicians and the MRE raters, however, was relatively poor (63.1%; 95% CI, 50.2%-74.7%).
  
  
  CONCLUSIONS
  Our findings suggest that while clinicians may overestimate, and current MRE techniques may underestimate, the presence of taut bands, these bands do exist, can be assessed quantitatively, and do represent localized areas of increased muscle stiffness.
authors.affiliation: Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN.
authors.forename: Qingshan
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN.
authors.forename: Hua-jun
authors.initials: HJ
authors.lastname: Wang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.
authors.forename: Ralph E
authors.initials: RE
authors.lastname: Gay
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Thompson
authors.affiliation: Department of Radiology, Center for Advanced Imaging Research, Mayo Clinic, Rochester, MN.
authors.forename: Armando
authors.initials: A
authors.lastname: Manduca
authors.affiliation: Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN.
authors.forename: Kai-Nan
authors.initials: KN
authors.lastname: An
authors.affiliation: Department of Radiology, Center for Advanced Imaging Research, Mayo Clinic, Rochester, MN.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Ehman
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN. Electronic address: basford.jeffrey@mayo.edu.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Basford
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000175:diagnosis*; D015588:Observer Variation; D064171:Superficial Back Muscles / Q000503:physiopathology; D061028:Trigger Points / Q000503:physiopathology*; D055815:Young Adult
keywords: Elasticity imaging techniques; Magnetic resonance imaging; Muscles; Rehabilitation