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74 Can the ultrasound-guided dry-needling associated with elastosonographic evaluation improve the treatment of the myofascial trigger points?
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  1. P Fusco1,
  2. M Celniku2,
  3. W Ciaschi3,
  4. F Angelucci2 and
  5. F Marinangeli2
  1. 1San Salvatore Academic Hospital, Department of Anesthesia and Intensive Care, L’Aquila, Italy
  2. 2University of L’Aquila, Department of Life, Health and Environmental Sciences, L’Aquila, Italy
  3. 3F. Spaziani Academic Hospital, Department of Anesthesia and Intensive Care, Frosinone, Italy

Abstract

Background and Aims Muscular injuries are very common in sport practioners. The diagnosis is based generally in clinical examination. (1) Ultrasonography and elastosonography could provide a more accurate diagnosis of musculoskeletal pain. (1,2) The dry-needling tecnique has been showed to be an effective therapy for myofascial trigger points.(3)

Methods We report the case of a 28 years-old cyclist with pain in the left inguinal region and medial region of the left thigh (vas score 2 at rest), which was accentuated by external rotation movements and lateral knives (vas score 6). The clinical examination showed left adductor muscles swelling and stiffness with deep palpation pain. With the patient in the supine position and 30° external rotation of the lower limb, the ultrasonography associated with elastosonography showed signs of left adductor muscle contracture (blue cromatic areas). Figure 1

Results Ultrasound-guided dry-needling was performed with a sterile seirina j-type acupuncture needle, size n° 8 causing evocation of twiches of the left adductor muscles. At the end of therapy, the elastosonography re-evaluation showed signs of revascularization and major elasticity of the treated area (red cromatic areas) figure 2, there was no muscle swelling and stiffness, VAS score 0.

During the 25th-day follow-up, the patient refered muscle fatigue at the end of training, VAS score 1–2. A second dry-needling procedure was repeated, the patient reported VAS score 0 and the elastosonography showed signs of revascularization and major elasticity. Figure 3

Conclusions Our clinical and elastosonographic results, confirm that dry-needling may be an effective therapeutical option for musculoskeletal pain caused by myofascial trigger points.

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