Guido C. Robotti MD, Presenter: Nothing to Disclose

Alain Mayer, Abstract Co-Author: Nothing to Disclose

Sergio Cattaneo, Abstract Co-Author: Nothing to Disclose

To determine if sclerosing therapy with Polidocanol is an effective therapy for treating chronic tendon insertional pain in presence of areas of neovascularisation on colour Doppler.Chronic tendinosis is well known to be painful and difficult to treat. There is a lot of controversy about the origin of insertional pain of the tendons. Recent studies indicate that the occurrence of hypervascularisation correlates well with pain symptoms.

19 patients with chronic tendinosis (9 achillean, 3 patellar, 7 plantar fascia) were examined by colour Doppler. Hypervascularisation was estimated to be low, moderate or high according to the appearance inside the tendon and the surrounding tissue.Pain during activity was measured using a score from 1 to 5. Polidocanol (5mg/ml), an aliphatic non-ionised nitrogen-free anaesthetic was used as a sclerosing agent. The injection was performed with a 0.7 mm needle and a 5 ml syringue. Even though polidocanol is a local anaesthetic 3–5 ml Lidocain 1 % were injected s.c. prior to the injection of polidocanol.

Average pain during activity before treatment was 4.1 and hypervascularisation was estimated to be moderate in 8 and high in 11 patients.Patients were controlled clinically and by ultrasound after three to six weeks. 17 Patients had significant reduction of pain. In two patient there was no pain relief, treatment therefore was interrupted. These two patients had moderate vascularisation on CD. 6 patients had satisfactory results after the first treatment. In 11 cases with residual pain and hypervascularisation the treatment was repeated.After treatment in the 17 patients with satisfactory results pain was reduced to an average of 2.3 and there was a significant reduction of hypervascularisation which remained moderate only in 7 cases

Sclerosing therapy of hypervascular areas in chronic tendinosis under sonographic control is very effective in pain reduction.

Robotti, G, Mayer, A, Cattaneo, S, Colour Doppler Sonography-guided Sclerosing Therapy of Hypervascular Areas in Chronic Insertional Tendinosis.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4405628.html