Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy Study

Background: Latent myofascial trigger points (MTrPs) are clinically relevant because they lower local pressure pain thresholds (PPTs), can perturb motor control, and may sustain shoulder symptoms even when overt pain is absent. However, even if previous studies assessed stiffness and mechanosensitiv...

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Autores: Kobylarz, Mateusz D., Ortega-Santiago, Ricardo, Sánchez Jorge, Sandra, Sánchez-Jorge, Sandra, Kołacz, Marcin, Kosson, Dariusz, Monclús-Díez, Germán, Valera-Calero, Juan Antonio, López Redondo, Mónica, López-Redondo, Mónica
Formato: artículo
Fecha de publicación:2025
País:España
Recursos:Universidad de Málaga
Repositorio:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
Idioma:inglés
OAI Identifier:oai:ddfv.ufv.es:10641/6622
Acesso em linha:https://hdl.handle.net/10641/6622
Access Level:acceso abierto
Palavra-chave:diagnostic accuracy
myofascial pain syndrome
myofascial trigger points
pain pressure threshold
shear wave elastography
ultrasound imaging
Internal Medicine
Clinical Biochemistry
Journal Article
Yes
yes
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oai_identifier_str oai:ddfv.ufv.es:10641/6622
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spelling Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy StudyKobylarz, Mateusz D.Ortega-Santiago, RicardoSánchez Jorge, SandraSánchez-Jorge, SandraKołacz, MarcinKosson, DariuszMonclús-Díez, GermánValera-Calero, Juan AntonioLópez Redondo, MónicaLópez-Redondo, Mónicadiagnostic accuracymyofascial pain syndromemyofascial trigger pointspain pressure thresholdshear wave elastographyultrasound imagingInternal MedicineClinical BiochemistryJournal ArticleYesyesBackground: Latent myofascial trigger points (MTrPs) are clinically relevant because they lower local pressure pain thresholds (PPTs), can perturb motor control, and may sustain shoulder symptoms even when overt pain is absent. However, even if previous studies assessed stiffness and mechanosensitivity differences between MTrPs and asymptomatic regions, objective patient-level cut-offs and diagnostic-accuracy metrics to distinguish latent MTrPs from adjacent asymptomatic tissue are lacking. Objective: To quantify the diagnostic accuracy of pressure algometry (PPT) and shear-wave elastography (SWE) for distinguishing latent MTrPs from adjacent asymptomatic tissue. Methods: A single-center cross-sectional study was conducted including 76 volunteers with ≥1 latent infraspinatus MTrP (assessed by following the current Delphi consensus criteria). The most sensitive latent MTrP and a control site 2 cm cranial was measured on the dominant side infraspinatus muscle in each participant. PPT and SWE were acquired with a standardized protocol (long-axis imaging, anisotropy control, minimal probe pressure; three captures per site; 1 cm rectangular ROI; operator blinded to site type). ROC analyses estimated areas under the curve (AUCs), Youden-optimal cut-offs, sensitivity, specificity, and likelihood ratios (LR+/−). Results: Latent MTrPs showed lower PPTs than controls (p < 0.001) and higher stiffness (shear modulus: p = 0.009; shear-wave speed: p = 0.022). PPT yielded AUC = 0.704 with an optimal cut-off of 47.5 N (sensitivity 0.75; specificity 0.592; LR+ 1.84; LR− 0.42), outperforming SWE metrics (shear modulus AUC 0.611; cut-off 23.6 kPa; sensitivity 0.632; specificity 0.605; LR+ 1.60; LR− 0.61; shear-wave speed AUC 0.601; cut-off 2.55 m/s; sensitivity 0.592; specificity 0.632; LR+ 1.61; LR− 0.65). Conclusions: In the infraspinatus, PPT provides moderate discrimination between latent MTrPs and adjacent asymptomatic tissue, whereas resting SWE—despite small mean differences—exhibited lower accuracy. These findings support mechanosensitivity as a primary measurable signal and position SWE as an adjunct. External validation across devices and operators, and multivariable models integrating sensory, imaging, and clinical features, are warranted.Facultad de Ciencias de la Salud20252025-10-0120252025-10-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10641/6622reponame:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoriainstname:Universidad de MálagaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddfv.ufv.es:10641/66222026-06-11T12:44:57Z
dc.title.none.fl_str_mv Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy Study
title Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy Study
spellingShingle Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy Study
Kobylarz, Mateusz D.
diagnostic accuracy
myofascial pain syndrome
myofascial trigger points
pain pressure threshold
shear wave elastography
ultrasound imaging
Internal Medicine
Clinical Biochemistry
Journal Article
Yes
yes
title_short Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy Study
title_full Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy Study
title_fullStr Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy Study
title_full_unstemmed Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy Study
title_sort Determining Pain Pressure Thresholds and Muscle Stiffness Cut-Offs to Discriminate Latent Myofascial Trigger Points and Asymptomatic Infraspinatus Muscle Locations : A Diagnostic Accuracy Study
dc.creator.none.fl_str_mv Kobylarz, Mateusz D.
Ortega-Santiago, Ricardo
Sánchez Jorge, Sandra
Sánchez-Jorge, Sandra
Kołacz, Marcin
Kosson, Dariusz
Monclús-Díez, Germán
Valera-Calero, Juan Antonio
López Redondo, Mónica
López-Redondo, Mónica
author Kobylarz, Mateusz D.
author_facet Kobylarz, Mateusz D.
Ortega-Santiago, Ricardo
Sánchez Jorge, Sandra
Sánchez-Jorge, Sandra
Kołacz, Marcin
Kosson, Dariusz
Monclús-Díez, Germán
Valera-Calero, Juan Antonio
López Redondo, Mónica
López-Redondo, Mónica
author_role author
author2 Ortega-Santiago, Ricardo
Sánchez Jorge, Sandra
Sánchez-Jorge, Sandra
Kołacz, Marcin
Kosson, Dariusz
Monclús-Díez, Germán
Valera-Calero, Juan Antonio
López Redondo, Mónica
López-Redondo, Mónica
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Facultad de Ciencias de la Salud
dc.subject.none.fl_str_mv diagnostic accuracy
myofascial pain syndrome
myofascial trigger points
pain pressure threshold
shear wave elastography
ultrasound imaging
Internal Medicine
Clinical Biochemistry
Journal Article
Yes
yes
topic diagnostic accuracy
myofascial pain syndrome
myofascial trigger points
pain pressure threshold
shear wave elastography
ultrasound imaging
Internal Medicine
Clinical Biochemistry
Journal Article
Yes
yes
description Background: Latent myofascial trigger points (MTrPs) are clinically relevant because they lower local pressure pain thresholds (PPTs), can perturb motor control, and may sustain shoulder symptoms even when overt pain is absent. However, even if previous studies assessed stiffness and mechanosensitivity differences between MTrPs and asymptomatic regions, objective patient-level cut-offs and diagnostic-accuracy metrics to distinguish latent MTrPs from adjacent asymptomatic tissue are lacking. Objective: To quantify the diagnostic accuracy of pressure algometry (PPT) and shear-wave elastography (SWE) for distinguishing latent MTrPs from adjacent asymptomatic tissue. Methods: A single-center cross-sectional study was conducted including 76 volunteers with ≥1 latent infraspinatus MTrP (assessed by following the current Delphi consensus criteria). The most sensitive latent MTrP and a control site 2 cm cranial was measured on the dominant side infraspinatus muscle in each participant. PPT and SWE were acquired with a standardized protocol (long-axis imaging, anisotropy control, minimal probe pressure; three captures per site; 1 cm rectangular ROI; operator blinded to site type). ROC analyses estimated areas under the curve (AUCs), Youden-optimal cut-offs, sensitivity, specificity, and likelihood ratios (LR+/−). Results: Latent MTrPs showed lower PPTs than controls (p < 0.001) and higher stiffness (shear modulus: p = 0.009; shear-wave speed: p = 0.022). PPT yielded AUC = 0.704 with an optimal cut-off of 47.5 N (sensitivity 0.75; specificity 0.592; LR+ 1.84; LR− 0.42), outperforming SWE metrics (shear modulus AUC 0.611; cut-off 23.6 kPa; sensitivity 0.632; specificity 0.605; LR+ 1.60; LR− 0.61; shear-wave speed AUC 0.601; cut-off 2.55 m/s; sensitivity 0.592; specificity 0.632; LR+ 1.61; LR− 0.65). Conclusions: In the infraspinatus, PPT provides moderate discrimination between latent MTrPs and adjacent asymptomatic tissue, whereas resting SWE—despite small mean differences—exhibited lower accuracy. These findings support mechanosensitivity as a primary measurable signal and position SWE as an adjunct. External validation across devices and operators, and multivariable models integrating sensory, imaging, and clinical features, are warranted.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025-10-01
2025
2025-10-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10641/6622
url https://hdl.handle.net/10641/6622
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2

http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2

http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
instname:Universidad de Málaga
instname_str Universidad de Málaga
reponame_str DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
collection DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812455

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