International Journal of Osteopathic Medicine, 2005/03, 8(1):22-28. doi: 10.1016/j.ijosm.2004.10.001, type of study: ,ct,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (http://www.sciencedirect.com/science/article/pii/S1746068905000039)

Keywords:

palpation [217]
paraspinal muscles [7]
palpation [217]
tissue texture [3]
ultrasonography [27]
clinical trial [674]

Abstract:

Background Segmental paraspinal tissue texture irregularity and tenderness, particularly when detected in the paravertebral gutter (PVG), has been proposed to be an important diagnostic sign of intervertebral somatic dysfunction. The pathophysiology of tissues underlying sites that appear ‘abnormal to palpation and are reported tender’ (AbPT) by the subject, is speculative, but it has been suggested that a difference in paraspinal muscle size in these regions could produce segmental tissue texture abnormalities. This study aimed to examine whether there was a difference in paraspinal muscle size between AbPT and ‘normal to palpation and non-tender’ (NT) sites located in the PVG. Methods An experienced osteopath examined the thoracic PVG regions of 40 subjects (14 males, 26 females, age range 19–33 years, mean (SD)=22.3 (3.3); 33 asymptomatic, seven with mild thoracic symptoms) to detect an AbPT site in each individual. Three NT regions (immediately above, below and opposite the AbPT site) were also located, and the sites were marked with numbered stickers. An experienced ultrasonographer, who was blinded to the status of the marked regions, measured the anteroposterior cross-sectional dimension (thickness) of the paraspinal muscle bulk directly underlying each marked location, using diagnostic ultrasound. Results The AbPT and NT regions had similar mean anteroposterior dimensions (AbPT: 1.11cm±0.36, NT above: 1.12cm±0.34, NT below: 1.20cm±0.46, NT opposite: 1.10cm±0.36), and a one-way ANOVA determined that these means were not significantly different from each other (F3,156=0.606, P=0.612). Conclusions The results of this study suggest that factors other than differences in paraspinal muscle thickness are likely to account for abnormal tissue texture detected with palpation in the thoracic PVG regions of young, largely asymptomatic adults.