Test-retest reliability of the isometric contraction test (IC test) of the masticatory muscles in subjects with and without temporomandibular muscle disorders

Abstract Recently, the DC/TMD has become an essential tool for the diagnosis of temporomandibular disorders (TMD). However, as they fail to include functional activities, new assessment proposals have emerged, such as the isometric contraction test (IC test) of the masticatory muscles, which uses muscle contractions to identify muscular TMD. Objective This study aimed to determine the test-retest reliability of the IC test. Methods A total of 64 participants (40 women and 24 men) completed the IC test administered by two different physical therapists on two non-consecutive days. Cohen's kappa (k), PABAK, and percent agreement (PA) between days were estimated. Results The IC test showed good to excellent test-retest reliability values (k>0.77; PABAK>0.90), both globally and individually for the muscles evaluated, and PA>90%, therefore above the thresholds for clinical applicability. However, the global assessment of myofascial pain and the evaluation of the medial pterygoid muscle showed slightly lower reliability values. Conclusion The IC test is reliable for the assessment of subjects with muscular TMD, both in terms of the global assessment and the evaluation of each muscle, which supports its clinical applicability. Care should be taken when assessing myofascial pain globally and when evaluating the medial pterygoid in all types of pain.

Focal myositis associated with Leishmania spp. infection in a dog - diagnostic approach / Miosite focal associada à infecção por Leishmania spp. em um cão - abordagem diagnóstica

ABSTRACT: Canine visceral leishmaniasis is a systemic, zoonotic disease widely spread in several countries. The disease is caused by Leishmania spp., and the dog is the main reservoir of this parasite. Clinical signs in the muscle skeletal system consist of muscle atrophy, weakness, lameness, abnormal locomotion, osteitis, polyarthritis, heat and swelling of the joints, enlarged local lymph nodes and pain. In this note, a case of canine myositis of the lumbar region associated with Leishmania spp. infection is reported. Clinical signs included weakness, fever, mild dehydration, enlarged mandibular, pre-scapular and popliteal lymph nodes and a large palpable soft mass in the lumbar region, semi-adhered and not painful. Serologic diagnosis resulted reagent by indirect immunofluorescence reaction method. Findings of ultrasonography of the lower back are described, revealing the misalignment of muscle fibers, interspersed with anechoic areas compatible with edema. Local fine needle aspiration cytology was crucial for a definitive diagnosis, revealing amastigote forms. In endemic areas of leishmaniasis, clinicians should consider this disease as a differential diagnosis in the presence of musculoskeletal injuries with no apparent cause.

RESUMO: A leishmaniose canina visceral é uma doença sistêmica, zoonótica e amplamente difundida causada por parasitas do gênero Leishmania spp., sendo o cão importante hospedeiro. Os sinais clínicos de leishmaniose no sistema músculo esquelético se constituem em atrofia muscular, fraqueza, claudicação, locomoção anormal, osteíte, poliartrite, hipertermia, dor e edema das articulações. A presente nota descreve um caso de miosite lombar em cão associada à infecção por Leishmania spp. Os sinais clínicos incluíram fraqueza, febre, desidratação leve, aumento dos linfonodos mandibulares, pré-escapulares e poplíteos e uma grande massa macia palpável na região lombar, semi-aderida e não dolorosa. O diagnóstico sorológico resultou em reagente pelo método da reação de imunofluorescência indireta totalmente diluída. Os achados da ultrassonografia da região lombar são descritos, revelando o desalinhamento das fibras musculares, intercaladas com áreas anecóicas, compatíveis com edema. A citologia local de aspiração por agulha fina foi crucial para o diagnóstico definitivo, revelando formas amastigotas. Nas áreas endêmicas da leishmaniose, deve-se considerar esta doença como diagnóstico diferencial na presença de lesões musculoesqueléticas sem causa aparente.

Relationship between the Serum CPK and the Shoulder Muscle Disorder in VDT Workers / 대한산업의학회지

VDT workers are often exposed to static load in the shoulder stabilizing muscle due to repetitive work over long periods. Many investigations were reported the relationships between static load due to repetitive work and regional muscle disorder. However, diagnostic approach to work-related muscle disorder is difficult due to the absence of objective diagnostic tools. This study was performed to investigate the relationship between the serum CPK (creatine phosphokinase) concentrations and the shoulder muscle disorders. Results are as follow. 1. Mean serum CPK in total VDT workers was 67.6+/-28.4 IU/l and workers with abnormal serum CPK were 35 (21.5%). 2. Comparison between cases and controls did not show significant difference in the serum CPK level and the distribution of abnormal findings. 3. Sensitivity and specificity of the CPK test was 23.0% and 82.0%, respectively. Above results, in accordance with literatures, show that while serum CPK measure menu can be useful for the diagnosis of acute muscle injury, it does not adequately reflect the muscle disorders developed by the repetitive work of low tension over long time, such as VDT works.