Literature ReviewAssessment of Myofascial Trigger Points via Imaging A Systematic ReviewMazza, Dario F. MSc; Boutin, Robert D. MD; Chaudhari, Abhijit J. PhD Author Information From the Department of Radiology, University of California, Davis, Sacramento, California (DFM, AJC); and Department of Radiology, Stanford University School of Medicine, Stanford, California (RDB). All correspondence should be addressed to: Abhijit J. Chaudhari, PhD, Department of Radiology, University of California Davis, 4860 Y St, Suite 3100, Sacramento, CA 95817. Supported by the National Institutes of Health (Grant R01AR076088). Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ajpmr.com). American Journal of Physical Medicine & Rehabilitation: October 2021 - Volume 100 - Issue 10 - p 1003-1014 doi: 10.1097/PHM.0000000000001789 Buy SDC Metrics Abstract This study systematically reviewed the published literature on the objective characterization of myofascial pain syndrome and myofascial trigger points using imaging methods. PubMed, Embase, Ovid, and the Cochrane Library databases were used, whereas citation searching was conducted in Scopus. Citations were restricted to those published in English and in peer-reviewed journals between 2000 and 2021. Of 1762 abstracts screened, 69 articles underwent full-text review, and 33 were included. Imaging data assessing myofascial trigger points or myofascial pain syndrome were extracted, and important qualitative and quantitative information on general study methodologies, study populations, sample sizes, and myofascial trigger point/myofascial pain syndrome evaluation were tabulated. Methodological quality of eligible studies was assessed based on the Quality Assessment of Diagnostic Accuracy Studies criteria. Biomechanical properties and blood flow of active and latent myofascial trigger points assessed via imaging were found to be quantifiably distinct from those of healthy tissue. Although these studies show promise, more studies are needed. Future studies should focus on assessing diagnostic test accuracy and testing the reproducibility of results to establish the best performing methods. Increasing methodological consistency would further motivate implementing imaging methods in larger clinical studies. Considering the evidence on efficacy, cost, ease of use and time constraints, ultrasound-based methods are currently the imaging modalities of choice for myofascial pain syndrome/myofascial trigger point assessment. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.