From the Guidelines
An ultrasound can potentially show causes of sternocleidomastoid pain but not the pain itself, as it can visualize structural abnormalities such as tears, hematomas, inflammation, or tumors that might be causing pain. According to the guidelines for adult stroke rehabilitation and recovery from the American Heart Association/American Stroke Association 1, ultrasound may be considered as a diagnostic tool for soft tissue injury, which can be applied to the evaluation of sternocleidomastoid pain. The procedure works by using sound waves to create images of the muscle's structure, allowing clinicians to identify thickening, fluid collection, or disruption of normal muscle architecture.
- Key points to consider when using ultrasound for sternocleidomastoid pain evaluation include:
- Ultrasound is useful for visualizing structural abnormalities in the muscle
- It is a non-invasive and relatively accessible imaging modality for this muscle
- Other imaging modalities like MRI might be considered for more detailed evaluation if ultrasound findings are inconclusive
- A physical examination should typically be performed first to identify potential structural causes of the pain
- Pain is a subjective symptom that cannot be directly visualized on any imaging study, including ultrasound 1.
- In clinical practice, the use of ultrasound for diagnosing sternocleidomastoid pain would be based on a thorough physical examination and clinical suspicion of a structural cause, as recommended by the guidelines 1.
From the Research
Ultrasound Imaging for Sternocleidomastoid Pain
- Ultrasound imaging can be used to visualize the sternocleidomastoid muscle and detect abnormalities such as myofascial trigger points 2.
- A study published in 2017 used ultrasound imaging to investigate the effect of ischemic compression on the elastic behavior of active trigger points in the sternocleidomastoid muscle 2.
- The study found that ischemic compression significantly improved headache intensity, frequency, and duration, as well as pressure tolerance and pressure pain threshold, in subjects with cervicogenic headache originating from myofascial trigger points in the sternocleidomastoid muscle 2.
Detection of Sternocleidomastoid Pain
- Sternocleidomastoid pain can be detected through physical examination and patient history, but imaging studies such as ultrasound may also be useful in diagnosing and treating the condition 3, 4, 2.
- A case study published in 2004 described a patient with sternocleidomastoid syndrome, which was diagnosed and treated through a combination of passive and active treatments 4.
- Another study published in 2018 investigated the effects of soft tissue release intervention on the sternocleidomastoid and suboccipital muscles, and found that it significantly decreased muscle hardness and increased pressure pain threshold in smartphone users with latent myofascial trigger points 3.
Limitations of Ultrasound Imaging
- While ultrasound imaging can be useful in detecting and treating sternocleidomastoid pain, it may not be able to detect all types of abnormalities, such as focal myositis, which is a rare inflammatory lesion of skeletal muscle 5.
- Further research is needed to fully understand the role of ultrasound imaging in diagnosing and treating sternocleidomastoid pain, and to determine its limitations and potential applications 3, 4, 2, 5.