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Elastography

USING ULTRASOUND ELASTOGRAPHY TO IDENTIFY TRIGGER POINTS

Ultrasound Elastography has been used for years to diagnose prostate, breast or liver tumors.
Wolfgang Bauermeister,M.D. PhD from Munich, Germany, a US trained physiatrist, started his research in the year 2000 to diagnose myofascial trigger points in athletes and pain patients with real-time Elastography. He worked with other researchers from the University of Bochum, Germany who used this method to diagnose prostate tumors. It was Dr. Bauermeister’s idea to apply this technique to MTrPs, because they are hard, non-elastic areas within the muscle, comparable to a prostate tumor within the otherwise soft prostate muscle. A conventional high-end ultrasound scanner was hooked up to a computer, which performed real- time analysis of the raw ultrasound signals. By applying rhythmic pressure to the muscle with the ultrasound probe, the computer recorded a stream of signals of the compression and the non-compression phase. The difference between the two signals was calculated and translated into a colored “strain image”, which indeed showed MTrPs. While the resolution at that time was pretty low, it was possible to differentiate between dark, hard areas and red or yellow soft areas . Bauermeister concluded, that with real time Elastography, it was possible to image MTrPs. Comparing the images before (Figure 2) and after Shockwave therapy (Figure 3) he found a significant change in the strain images from hard to soft.