HMG-CoA lyase deficiency
Jan. 03, 2022
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Essential (solid red) and spillover (stippled red) referred pain from TP-6 (x) in the left middle trapezius refers aching pain to the top of the shoulder. TP-7 (x) on the right, lies within the encircled area of the middle trapezius and can produce a nonpainful autonomic response with pilomotor erection (gooseflesh) on the lateral aspect of the ipsilateral arm and sometimes also of the thigh. The zone to which it refers pilomotor activity is identified on the right upper extremity. (From Travell JG, Simons DG. Myofascial pain and dysfunction, trapezius muscle, the trigger point manual. Volume 1. Baltimore: Williams & Wilkins, 1983:186, with permission.)