E Zeisig1, M Fahlström, L Ohberg, H Alfredson. 1. Sports Medicine Unit, Department of Surgical and Perioperative Science, University of Umeå, 901 87 Umeå, Sweden. eva.zeisig@vll.se
Abstract
BACKGROUND: Tennis elbow is a tendinopathy affecting the upper extremity. Recent studies have shown high sensitivity for ultrasound (US) examination and high specificity for colour Doppler (CD) examination. There are no mid- or long-term follow-up investigations of the tendon structure and blood flow using these techniques. OBJECTIVE: To use US and CD to study structure and blood flow in the extensor origin in patients with tennis elbow treated with intratendinous injections. DESIGN: Follow-up study. SETTING: Sports Medicine Unit, Umeå University. PATIENTS: 25 patients (28 elbows), mean age 46 years (range 27-66), treated with intratendinous injections due to chronic pain from tennis elbow. METHOD: US and CD examination of the extensor origin was carried out at inclusion and at follow-up two years after intratendinous injection treatment with polidocanol and/or a local anaesthetic. MAIN OUTCOME MEASUREMENTS: US (structure) and CD (blood flow) findings. RESULTS: All patients had structural tendon changes and high blood flow at inclusion when given the injection treatment. At the two-year follow-up, structural tendon changes were seen in 20/28 elbows and high blood flow was seen in 4/28 elbows. The majority of patients with a good clinical result after treatment had no visible blood flow (17/20), but the structural changes showed no relation to a good result (13/20 remaining changes). CONCLUSIONS: Doppler findings, but not structure, might be related to the clinical result after intratendinous injection treatment of tennis elbow.
BACKGROUND:Tennis elbow is a tendinopathy affecting the upper extremity. Recent studies have shown high sensitivity for ultrasound (US) examination and high specificity for colour Doppler (CD) examination. There are no mid- or long-term follow-up investigations of the tendon structure and blood flow using these techniques. OBJECTIVE: To use US and CD to study structure and blood flow in the extensor origin in patients with tennis elbow treated with intratendinous injections. DESIGN: Follow-up study. SETTING: Sports Medicine Unit, Umeå University. PATIENTS: 25 patients (28 elbows), mean age 46 years (range 27-66), treated with intratendinous injections due to chronic pain from tennis elbow. METHOD: US and CD examination of the extensor origin was carried out at inclusion and at follow-up two years after intratendinous injection treatment with polidocanol and/or a local anaesthetic. MAIN OUTCOME MEASUREMENTS: US (structure) and CD (blood flow) findings. RESULTS: All patients had structural tendon changes and high blood flow at inclusion when given the injection treatment. At the two-year follow-up, structural tendon changes were seen in 20/28 elbows and high blood flow was seen in 4/28 elbows. The majority of patients with a good clinical result after treatment had no visible blood flow (17/20), but the structural changes showed no relation to a good result (13/20 remaining changes). CONCLUSIONS: Doppler findings, but not structure, might be related to the clinical result after intratendinous injection treatment of tennis elbow.
Authors: Blanca De-la-Cruz-Torres; Vanesa Abuín-Porras; Emmanuel Navarro-Flores; César Calvo-Lobo; Carlos Romero-Morales Journal: Int J Environ Res Public Health Date: 2021-05-03 Impact factor: 3.390