Emanuele Fabbro MD, Presenter: Nothing to Disclose

Luca Maria Sconfienza MD, Abstract Co-Author: Nothing to Disclose

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

Francesca Lacelli 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

Achilles tendinopathy is a common cause of lower calf pain in general population. The purpose of our work was to compare the short- and long-term outcome of US-guided percutaneous treatment based on dry needling and peritendinous injection of steroid in these patients, compared with similar patients treated with simple steroid injection or dry needling.

IRB approval and informed consent were obtained. Among 45 patients referred for US-guided treatment of Achilles tendinopathy, 15 (8 males, 7 females; age 45.7±8.6 [mean±SD]) were treated with dry needling and local injection of steroid together; 15 (7 males, 8 females; age 47.2±11.8) were treated with dry needling only; 15 (11 males,14 females; age 50.7±10.0) were treated with local injection of steroid. Pain was assessed using the visual analogue scale (VAS) at baseline and at 7, 14, 30, 90, 180, 360 days after the procedure. Kruskall Wallis test was used.

Patients treated with the combined procedure had a faster and permanent decrease of symptoms (VAS at 7 days=1.1±0.5 and VAS at 360 days=0.0± 0.1). Patients treated only with injection of steroid had a quick decrease of pain that was not permanent on a long-term basis (VAS at 7 days=1.1±0.6 and VAS at 360 days=5.4± 0.4). Patients treated with needling only had a permanent but slower decrease of symptoms (VAS at 7 days=5.6±0.6, at 30 days VAS=2.8± 0.4, at 90 days VAS=0.4±0.8, and at 360 days VAS=0.1±0.2). Difference was statistically significant (p<.001). No immediate or delayed complications were observed.

Patients treated with the combined procedure had a better outcome than other groups. Pain relief is faster and more permanent compared with slower or not stable results obtained in the other patients.

The combined approach of needling and steroid injection seems to be the treatment of choice in patients affected by Achilles tendinopathy, compared to the other two partial treatments.

Fabbro, E, Sconfienza, L, Orlandi, D, Lacelli, F, Serafini, G, Silvestri, E, One-year Outcome of Ultrasound (US)-guided Percutaneous Treatment of Achilles Tendinopathy: Results of a Randomized Controlled Trial.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005527.html