State, Not Scar · claim VASO-C184 · Observation rung · The phenomenon at the fingertip

Active trigger point sites were significantly larger than latent sites on vibration elastography (P < .01).

Not featured in the current editionAI-extractedorigin: split of VASO-C033 (report 2026-09-09-report-vasocomputation-023157); anchored by the splitter in the same text

source anchor

Results

“active sites were significantly larger than latent sites ( P < .01)”

Evidence

Context· weakVASO-E085

Landfald 2025: active/latent differences in a second muscle as context for the graded-stiffness and fresh/old claims — part 2

what the source states: Active gastrocnemius MTrPs had a "larger cross-sectional area (28 mm² vs. 17 mm², p = 0.014)" than latent points; Table 2 gives 28 ± 6 against 17 ± 5 mm².
what we infer: Size by clinical class in a second muscle; the same parallel, carrying no weight for or against the fresh/old claims.
limitations: Different muscle, method and site classes from the trapezius sonoelastography study.
Active/latent is not the fresh/old axis; the authors' 'earlier or less fibrotic' reading is their conjecture.
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-verify-vasocomputation-113521, verify-v6) found the passage bears on VASO-C033 and not on VASO-C075, VASO-C076; the links dropped at intake: The quoted active-vs-latent comparison (VAS, cross-sectional area, stiffness ratio) is accurately drawn from Table 2/Discussion and is genuinely a different-muscle analogue that can serve as context for the trapezius active/latent claim C033. But the quoted statement says nothing about session counts, duration, or knot age/freshness, so it does not bear at all on the fresh-knot (C075) or ancient-knot (C076) claims about time-to-release, despite the record listing 'context' for all three.
One clause of a three-part comparison the source reports in one sentence and one table; the sibling parts carry the other two.

Ingrid C. Landfald (2025)AI-verified citation

Supports· moderateVASO-E087

Ballyns 2011: vibration sonoelastography stiff-area measurements separate active, latent and normal sites — part 1.1

what the source states: On sonoelastography, active sites (spontaneously painful with palpable myofascial trigger points) had larger trigger points, with a mean ± SD area of 0.57 ± 0.20 cm², as stated: "active sites (spontaneously painful with palpable myofascial trigger points) had larger trigger points".
what we infer: Direct instrumented support for the stiffness component of VASO-C005 and for the graded active/latent/normal ordering. Sonographers were blinded to clinical status, which is stronger than the palpation-only literature. It says nothing about what the stiff tissue is (contracted fibre, guarding, fascial change, or vascular).
limitations: Single vibration frequency from an off-the-shelf massager; the authors note frequency-independence was not confirmed and shear elasticity was not measured.
Sites were selected by palpation, so the measured contrast presupposes the palpated classification.
Same NIH lineage as SRC-SHAH-2008; not an independent group.
Relinked at the answer's re-reading 2026-09-20 (2026-09-20-answer-vasocomputation-172213): VASO-C033 was split into VASO-C182, VASO-C183, VASO-C184; this record now cites the parts, and which of them it bears on is for a later reading
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-reverify-vasocomputation-190441, verify-v6) found the passage bears on VASO-C005, VASO-C182, VASO-C184 and not on VASO-C183; the link dropped at intake: The quoted phrase and the 0.57\u00b10.20 cm\u00b2 active-site value are accurately drawn from the Results/Abstract and are at the stated locator, and the statement is a fair, non-inflated account of that value, so it supports the general difference claim (C005) and, since the active value matches exactly what is needed for the active-vs-latent comparison, also bears on C182 and C184. But it says nothing about the normal-site value (0.17\u00b10.22) needed to support C183's active-and-latent-vs-normal comparison, so that claim is not borne on by this passage. Independence is properly flagged in the limitations, and the record is a single atomic proposition.

Jeffrey J. Ballyns (2011)AI-verified citation

Supports· moderateVASO-E092

Ballyns 2011: vibration sonoelastography stiff-area measurements separate active, latent and normal sites — part 2.2

what the source states: By vibration elastography, "active sites were significantly larger than latent sites" (P < .01).
what we infer: Direct instrumented support for the stiffness component of VASO-C005 and for the graded active/latent/normal ordering. Sonographers were blinded to clinical status, which is stronger than the palpation-only literature. It says nothing about what the stiff tissue is (contracted fibre, guarding, fascial change, or vascular).
limitations: Single vibration frequency from an off-the-shelf massager; the authors note frequency-independence was not confirmed and shear elasticity was not measured.
Sites were selected by palpation, so the measured contrast presupposes the palpated classification.
Same NIH lineage as SRC-SHAH-2008; not an independent group.
Relinked at the answer's re-reading 2026-09-20 (2026-09-20-answer-vasocomputation-172213): VASO-C033 was split into VASO-C182, VASO-C183, VASO-C184; this record now cites the parts, and which of them it bears on is for a later reading
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-reverify-vasocomputation-190441, verify-v6) found the passage bears on VASO-C005, VASO-C182, VASO-C184 and not on VASO-C183; the link dropped at intake: The quoted sentence accurately reports the active-versus-latent size comparison (P<.01) from the Results section, and its statement is a fair, narrow account of that specific finding. It directly supports VASO-C184 (active > latent) and generally supports VASO-C005's broader claim about stiffness differences, but it says nothing about the specific magnitude values in C182 (0.57 vs 0.36 cm²) or about the active/latent-versus-normal comparison in C183, so it only bears as context on C182 and not at all on C183.
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-reverify-vasocomputation-190441, verify-v6) found the passage bears in different directions on the claims the record named; this record carries "supports" toward VASO-C005, VASO-C184, the rest went to a record of its own at intake: The quoted sentence accurately reports the active-versus-latent size comparison (P<.01) from the Results section, and its statement is a fair, narrow account of that specific finding. It directly supports VASO-C184 (active > latent) and generally supports VASO-C005's broader claim about stiffness differences, but it says nothing about the specific magnitude values in C182 (0.57 vs 0.36 cm²) or about the active/latent-versus-normal comparison in C183, so it only bears as context on C182 and not at all on C183.

Jeffrey J. Ballyns (2011)AI-verified citation

Supports· moderateVASO-E099

Ballyns 2011: vibration sonoelastography stiff-area measurements separate active, latent and normal sites — part 4.3

what the source states: Trigger point area measurements were "fair classifiers of active versus latent sites" (cutoff point 0.4; AUC 0.8; P < .01).
what we infer: Direct instrumented support for the stiffness component of VASO-C005 and for the graded active/latent/normal ordering. Sonographers were blinded to clinical status, which is stronger than the palpation-only literature. It says nothing about what the stiff tissue is (contracted fibre, guarding, fascial change, or vascular).
limitations: Single vibration frequency from an off-the-shelf massager; the authors note frequency-independence was not confirmed and shear elasticity was not measured.
Sites were selected by palpation, so the measured contrast presupposes the palpated classification.
Same NIH lineage as SRC-SHAH-2008; not an independent group.
Relinked at the answer's re-reading 2026-09-20 (2026-09-20-answer-vasocomputation-172213): VASO-C033 was split into VASO-C182, VASO-C183, VASO-C184; this record now cites the parts, and which of them it bears on is for a later reading
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-reverify-vasocomputation-190441, verify-v6) found the passage bears on VASO-C005, VASO-C184 and not on VASO-C182, VASO-C183; the links dropped at intake: The quoted ROC statistic (fair classifier, cutoff 0.4, AUC 0.8, P<.01) is accurately quoted and correctly located in the Results section, and it does support the general finding of measurable differences (C005) and corroborates that active sites are distinguishable in area from latent sites (C184). However, it does not report the specific mean ± SD area values for active vs latent (C182) nor the active/latent-vs-normal comparison (C183), so the passage does not bear on those two split claims. The record correctly notes shared NIH lineage with the Shah 2008 source.

Jeffrey J. Ballyns (2011)AI-verified citation

Supports· moderateVASO-E104

Ballyns 2011: vibration sonoelastography stiff-area measurements separate active, latent and normal sites — part 3 — toward VASO-C182, VASO-C183, VASO-C184 — part 1

what the source states: Receiver operating characteristic analysis showed that trigger point "area measurements could robustly distinguish between active, latent, and normal sites".
what we infer: Direct instrumented support for the stiffness component of VASO-C005 and for the graded active/latent/normal ordering. Sonographers were blinded to clinical status, which is stronger than the palpation-only literature. It says nothing about what the stiff tissue is (contracted fibre, guarding, fascial change, or vascular).
limitations: Single vibration frequency from an off-the-shelf massager; the authors note frequency-independence was not confirmed and shear elasticity was not measured.
Sites were selected by palpation, so the measured contrast presupposes the palpated classification.
Same NIH lineage as SRC-SHAH-2008; not an independent group.
Relinked at the answer's re-reading 2026-09-20 (2026-09-20-answer-vasocomputation-172213): VASO-C033 was split into VASO-C182, VASO-C183, VASO-C184; this record now cites the parts, and which of them it bears on is for a later reading
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-reverify-vasocomputation-190441, verify-v6) found the passage bears in different directions on the claims the record named; this record carries "context" toward VASO-C182, VASO-C183, VASO-C184, the rest went to a record of its own at intake: The quoted sentence and AUC figures are accurately reported and correctly located in the Results/Abstract, and the source does not repeat another lab's independent dataset (correctly flagged as NIH-lineage overlap). However, the sourceStatement only reports the ROC/AUC classification finding, not the specific mean-area comparisons that VASO-C182, VASO-C183, and VASO-C184 assert; it therefore bears on the topic without directly establishing those specific quantitative claims, so it is better read as context for them, while it does support the broader claim (VASO-C005) that active sites differ measurably in stiffness/area from other tissue.
Direction set to "supports" (from "context") by the second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-answer-vasocomputation-192504, verify-v6) at intake: The quoted ROC/AUC 'robustly distinguish' finding sits in the same Results paragraph and rests on the same underlying area data as the specific mean-difference claims (active>latent>normal, each P<.01); a strong ROC/AUC separation between groups is itself evidence that the group means differ as the claims state, not merely background context. The quote is accurately located and rendered, the NIH lineage overlap is properly disclosed, and the statement is a single atomic proposition, but labeling it 'context' understates its evidentiary bearing on these three specific quantitative claims — it should be read as supporting evidence for each.
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-answer-vasocomputation-192504, verify-v6) disputes the stated direction toward VASO-C186: The quoted ROC/AUC 'robustly distinguish' passage is accurately quoted and correctly located in the Results/Abstract, and the NIH-lineage overlap is properly disclosed. But VASO-C186 asserts a distinct finding — that elastography-measured trigger point areas showed trends similar to pain pressure threshold scores — which is a separate sentence/observation in the same paragraph, not established or restated by the ROC/AUC discriminability statement quoted here. The classification-strength quote does not speak to whether the area trend paralleled the PPT trend, so it does not bear on this specific claim even though it comes from the same study and topic area.
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-answer-vasocomputation-192504, verify-v6) disputes the stated direction toward VASO-C187: The quoted ROC/AUC 'robustly distinguish' finding is accurately reported and correctly located, and NIH lineage overlap is properly disclosed, but it says nothing about the specific mean ± SD area value (0.17 ± 0.22 cm²) for normal sites that VASO-C187 asserts. A classification-strength statistic does not itself establish a particular descriptive mean, so the passage bears only as context on this specific quantitative claim rather than as direct support.
Corrected by the operator on 2026-09-20 (session_01AiXD4y5Y91KC7iM3uBhWmu, operator-by-hand-v1): relinked from VASO-C182, VASO-C185, VASO-C186, VASO-C187, VASO-C184 to VASO-C182, VASO-C187, VASO-C184, VASO-C188, VASO-C189 — its statement — area measurements distinguish active, latent and normal sites — bears on both comparisons against normal tissue; the bearing is read from the record's own statement, not from the reader, and stands for the panel's judgment

Jeffrey J. Ballyns (2011)AI-verified citation

Context· moderateVASO-E106

Ballyns 2011: vibration sonoelastography stiff-area measurements separate active, latent and normal sites — part 3 — toward VASO-C182, VASO-C183, VASO-C184 — part 2.3

what the source states: Trigger point area measurements from ROC analysis yielded an area under the curve of "0.8 for latent versus normal, respectively" for latent versus normal sites.
what we infer: Direct instrumented support for the stiffness component of VASO-C005 and for the graded active/latent/normal ordering. Sonographers were blinded to clinical status, which is stronger than the palpation-only literature. It says nothing about what the stiff tissue is (contracted fibre, guarding, fascial change, or vascular).
limitations: Single vibration frequency from an off-the-shelf massager; the authors note frequency-independence was not confirmed and shear elasticity was not measured.
Sites were selected by palpation, so the measured contrast presupposes the palpated classification.
Same NIH lineage as SRC-SHAH-2008; not an independent group.
Relinked at the answer's re-reading 2026-09-20 (2026-09-20-answer-vasocomputation-172213): VASO-C033 was split into VASO-C182, VASO-C183, VASO-C184; this record now cites the parts, and which of them it bears on is for a later reading
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-reverify-vasocomputation-190441, verify-v6) found the passage bears in different directions on the claims the record named; this record carries "context" toward VASO-C182, VASO-C183, VASO-C184, the rest went to a record of its own at intake: The quoted sentence and AUC figures are accurately reported and correctly located in the Results/Abstract, and the source does not repeat another lab's independent dataset (correctly flagged as NIH-lineage overlap). However, the sourceStatement only reports the ROC/AUC classification finding, not the specific mean-area comparisons that VASO-C182, VASO-C183, and VASO-C184 assert; it therefore bears on the topic without directly establishing those specific quantitative claims, so it is better read as context for them, while it does support the broader claim (VASO-C005) that active sites differ measurably in stiffness/area from other tissue.
Second reader (claude-sonnet-5, 2026-09-20, run 2026-09-20-answer-vasocomputation-192504, verify-v6) found the passage bears in different directions on the claims the record named; this record carries "context" toward VASO-C182, VASO-C184, the rest went to a record of its own at intake: The quoted AUC figure (0.8 for latent versus normal) is verbatim from the abstract and correctly located; it is a single, atomic statistical claim and the record properly flags NIH-lineage overlap. However, this ROC/AUC statistic on latent-versus-normal classification directly evidences the latent-vs-normal size difference asserted in VASO-C183, so it should be scored as supporting that claim rather than merely 'context'; it remains context for VASO-C182 (active-vs-latent means) and VASO-C184 (active-vs-latent significance), which it does not address.

Jeffrey J. Ballyns (2011)AI-verified citation

an honest empty state

This claim is in the ledger but not in the current edition's featured set. Nothing here has been assessed — that absence is information, not an oversight.

Still missing: plain-language gloss, credibility assessment, diagnosticity assessment, strongest objection, what would change our mind. A claim gains them when an edition features it and the edition's adopted assessment supplies the full treatment — a decision the panel reviews, not a field anyone flips.