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Anatomical substract of the Gluteus medius muscle myofascial trigger points: Preliminary results
Author(s) -
Akamatsu Flávia Emi,
Macaya Daniela Medina,
Itezerote Ana Maria,
Saleh Samir Omar,
Hojaij Flávio,
Andrade Mauro,
Jacomo Alfredo Luiz
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.lb2
Subject(s) - medius , medicine , anatomy , greater trochanter , orthodontics , physical medicine and rehabilitation , femur , surgery
Myofascial pain syndrome (MPS) is a common cause of chronic musculoskeletal pain and is characterized by myofascial trigger points (MTP), limited range of motion in joints, referred pain and local twitch response during mechanical stimulation of MTP. MTP are clinically identified by palpation of a taut band of muscle or fascia. Physiopathology of MPS remains unclear and it has been suggested that MTP occur when a nociceptor and a muscular motor endplate coincide. The gluteus medius muscle MTPs are prevalent in patellofemoral pain, back pain and can occur spontaneously gluteal pain, weakness in the lower limbs abduction and increased sensitivity. Three different MTP are clinically described for the gluteus medius muscle, but anatomical correlation is still lacking. Gluteus medius muscle from five cadavers were carefully dissected. We divided the gluteus medius muscle in four topographic áreas (I, II, III and IV) to describe the exact entry points of nerve fibers into the muscle. As these values vary with muscle size, the relative values of the insertion point was calculated from the average longitudinal (from the highest point of iliac crest to greater trochanter of the femur) and transverse dimension (the medium point of the longitudinal dimension) and categorized into four areas: I, II, III and IV. For a comparison of the number of points between the quadrants we have used generalized estimation equations with correlation matrix exchangeable between the quadrants, with marginal Poisson distribution and identity link function. For comparison of the quadrants 2 to 2 multiple Bonferroni comparisons were carried out. We observed that most of the gluteus medius muscle innervation occurred in quadrants I, II and IV of the muscle. These locations correspond to the clinically described MTP. Anatomical correlation of the MTP may be useful for a better understanding of the physiopathology of these disorders and provide basis for their treatment.