{
  "abstract": "Application for ESRA Abstract Prizes:Background and Aims Myofascial Pain Syndrome (MPS) is characterized by fascial thickening, stiffness, and impaired sliding of the fascial planes, primarily due to biochemical alterations such as increased viscosity of Hyaluronic Acid (HA). These changes hinder normal fascial mobility and contribute to persistent nociceptive input. Dynamic ultrasound (echodynamic imaging) offers a non-invasive method to assess these biomechanical alterations in real time.Methods We report the case of a 55-year-old male with chronic dorsolumbar pain (D8-D12) following D4-pelvic arthrodesis. Initial echodynamic imaging revealed a thickened, hyperechoic, and rigid fascia with poor gliding of muscle layers, consistent with myofascial stiffness. This baseline served for pre-treatment evaluation. A fascial block using 30 ml of 42 °C saline solution was administered under ultrasound guidance. Follow-up assessments were conducted at 15, 30, 60, and 90 days post-intervention.Results Echodynamic evaluations showed progressive improvement in fascial mobility. The most significant finding was the appearance of the ‘Binary Band’ sign, indicative of fascial layer separation and restored sliding capacity—absent at baseline. Clinically, the patient experienced a marked reduction in pain (NRS from 8 to 2), improved movement, and reduced muscle hypertrophy.Abstract P283 Figure 1Pre-treatment dynamic ultrasound image showing a thickened and hyperechoic fascia between the erector spinae muscle and the transverse process. The image highlights the lack of fascial layer sliding due to increased stiffness and density of the connective tissue, consistent with myofascial pain syndromeAbstract P283 Figure 2Post-treatment dynamic ultrasound image showing restoration of fascial mobility. The ‘Binary Band’ sign (white arrows) indicates the opening of the fascial layers and improved sliding of the interfascial planes, reflecting decreased stiffness and structural reorganization of the fasciaConclusions Dynamic ultrasound is a key tool for diagnosing and monitoring MPS. The combined evaluation of fascial layer gliding and the Binary Band sign offers objective, reproducible indicators of treatment efficacy, reflecting structural and functional fascial recovery. Moreover, ultrasound is a first-line, easily accessible, and low-cost imaging modality for musculoskeletal assessment, suitable for use in outpatient settings.",
  "authors": [
    {
      "affiliations": [
        "U.O.C Anestesia Rianimazione e Terapia del Dolore, P.O. Fabrizio Spaziani, Frosinone, Italy"
      ],
      "name": "Chiara Maggiani"
    },
    {
      "affiliations": [
        "U.O.C Anestesia Rianimazione e Terapia del Dolore, P.O. San Filippo e Nicola, Avezzano, Italy"
      ],
      "name": "Pierfrancesco Fusco"
    },
    {
      "affiliations": [
        "U.O.C Anestesia Rianimazione e Terapia del Dolore, P.O. Fabrizio Spaziani, Frosinone, Italy"
      ],
      "name": "Walter Ciaschi"
    }
  ],
  "title": "P283 Dynamic ultrasound assessment of fascial stiffness in chronic myofascial pain: diagnostic and follow-up role",
  "uid": "bf0f7f36-3ec7-5f5c-92a0-24a16caf1c64"
}