Masticatory myofascial pain syndrome is characterized by localized musculoskeletal pain in orofacial muscles such as the masseter and temporalis. In this pain syndrome, hyper-irritated nodules referred to as myofascial trigger points (MTrPs) cause local pain and mimic odontogenic pain when palpated.
Written by:
Quinn Pauli
Edited by:
Georgia Hadjis
MTrPs palpation is currently used to diagnose masticatory myofascial pain syndrome, where force is applied to masseter and temporalis muscles to assess pain and variation in muscle texture. However this examination has limited diagnostic accuracy and cannot provide information on the attributes of MTrPs. Ultrasonography, a sound wave-based imaging tool currently used in the diagnosis of musculoskeletal pathology, may have additional utility in diagnosing masticatory pain syndrome. UTCSP members Drs. Michael Goldberg, Howard Tenenbaum, Amir Azarpazhooh and their colleagues conducted a pragmatic cross-sectional clinical diagnosis study to assess the potential utility of ultrasonography in identifying MTrPs.
The primary aim of this study was to identify the concordance between ultrasonography and palpation in detecting MTrPs. Fifty-seven participants suspected of having temporomandibular disorder received both clinical palpation from a pain specialist and ultrasonography administered by a dentist. The two diagnostic methods were then compared across number of MTrPs identified, their distribution across muscle sections, and pain occurrence. The authors found that palpation identified more MTrPs and affected areas compared to ultrasonography. Ultrasonography and palpation concurred moderately-to-substantially in identifying the quantity of MTrPs and involved muscle sections, however they disagreed on the location of the MTrPs within muscle sections.
The results of this study indicate that ultrasonography, which is objective and straightforward to implement by endodontists, has the potential to be used as a diagnostic tool for masticatory myofascial pain syndrome. Compared to palpation, ultrasonography may enhance patient experience during examination while preventing misdiagnosis and unnecessary treatments that could exacerbate pain.
The results of this study indicate that ultrasonography, which is objective and straightforward to implement by endodontists, has the potential to be used as a diagnostic tool for masticatory myofascial pain syndrome.
