Luca Maria Sconfienza MD, Presenter: Nothing to Disclose

Francesca Lacelli MD, Abstract Co-Author: Nothing to Disclose

Emanuele Fabbro MD, Abstract Co-Author: Nothing to Disclose

Davide Orlandi MD, Abstract Co-Author: Nothing to Disclose

Giovanni Serafini MD, Abstract Co-Author: Nothing to Disclose

Enzo Silvestri MD, Abstract Co-Author: Nothing to Disclose

Lateral epicondylitis is a common cause of elbow pain in general population. We show the efficacy of two different percutaneous treatment under US guidance in treating this condition.

IRB approval and patients’ informed consent were obtained. Fourty-six patients (26 males, 20 females, mean age 45±8.6) suffering from lateral epicondylitis underwent an US-guided percutaneous treatment. They were randomly subdivided into two groups. In the first group (16 patients), under local anesthesia and US guidance, a needle was advanced into the enthesis of the common extensor tendon. There, we performed multiple punctures to obtain a scarification of the enthesis and of the preinsertional portion of the tendon. In a second group (16 patients), an US-guided steroid injection (1 mL of metilprednisolone acetate 40 mg/mL, Depo-Medrol, Pfizer, The Netherlands) around the enthesis was performed. A visual analogue scale was used to evaluate the degree of pain pre-and post-treatment at 2, 12, 24, 36 and 48 weeks. Wilcoxon and Mann-Whitney U test were used.

In the first group, no significant improvement compared to baseline was found at 2 weeks but was present at 12, 24, 36, and 48 weeks (p<.001 for all). In the second group, significant improvement compared to baseline was found at 2 weeks (p<.001) but not at 12, 24, 36, and 48 weeks. Comparison between the groups showed significant different outcome in favour of the second group at two weeks (p<.001) and in favour of the first group at 12, 24, 36, and 48 weeks (p<.001).

US-guided percutaneous dry-needling alone is more effective than steroid injection. The efficacy of this treatment seems to be long-lasting. It can be considered as an effective and minimally invasive treatment for lateral epicondylitis.

US-guided procedure could represent an poorly invasive, low-cost, and effective alternative to shockwaves or surgery for patients affected by lateral epicondylitis.

Sconfienza, L, Lacelli, F, Fabbro, E, Orlandi, D, Serafini, G, Silvestri, E, One Year Survey of Two Different Ultrasound (US)-guided Percutaneous Treatments of Lateral Epicondylitis: Results of a Prospective Randomized Trial.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9010067.html