Abstract Archives of the RSNA, 2011
Giulio Ferrero, Presenter: Nothing to Disclose
Emanuele Fabbro MD, Abstract Co-Author: Nothing to Disclose
Davide Orlandi MD, Abstract Co-Author: Nothing to Disclose
Chiara Martini MChir, Abstract Co-Author: Nothing to Disclose
Enzo Silvestri MD, Abstract Co-Author: Nothing to Disclose
Giacomo Garlaschi MD, Abstract Co-Author: Nothing to Disclose
Epitrochleitis is a common cause of elbow pain in golf players. The treatment of this disorder varies considerably and ranges from conservative treatments to surgical intervention. The purpose of our work was to compare patients with clinical diagnoses of epitrochleitis treated with a combined US-guided percutaneous approach, based on dry needling and local steroid injection and similar patients treated with either local steroid injection or dry needling.
IRB approval and informed consent were obtained. 30 patients suffering from epitrochleitis underwent to US-guided percutaneous treatment: 10 (7 males, 3 females; age 38.7±7.4[mean±standard deviation]) were treated with dry needling and local steroid injection together, 10 (6 males, 4 females; age 43.2±6.8) with dry needling only and 10 (3 males, 7 females; age 35.2±9.4) with local steroid injection only. A visual analogue scale (VAS from 0 to 10) was used to evaluate the degree of pain at baseline and at 2, 12, 24, 36, and 48 weeks after the procedure; US scanning was performed at baseline, at 24, and 48 weeks. Kruskall Wallis test was used.
No immediate or delayed complications were observed. Patients who underwent steroid injection only had a prompt pain decrease but limited effects on a long-term basis (at baseline VAS=6.9±0.3, at 2 weeks VAS=1.8±0.5, at 12 weeks VAS=4.0±0.3, at 24 weeks VAS=4.8±0.7,at 36 weeks VAS=5.3±0.6 and VAS at 48 weeks=7.1±0.3). Patients treated with dry needling only had a delayed decrease of symptoms but permanent long-lasting effects (at baseline VAS=7.6±0.4, at 2 weeks VAS=7.4±0.3, at 12 weeks VAS=3.1± 0.5, at 24 weeks VAS=1.1±0.8, at 36 weeks VAS=0.8±0.4 and at 48 weeks VAS=0.2±0.3). Patients treated with the combined procedure had a faster and more permanent decrease of symptoms (at baseline VAS=7.1±0.4, at 2 weeks VAS =2.3±0.6, at 12 weeks VAS= 2.6, at 24 weeks VAS=1.0±0.9, at 36 weeks VAS=0.7±0.6 and at 48 weeks VAS=0.1±0.5; p<.01 for all).
Patients treated with the US-guided combined procedure had a better outcome than other groups and pain relief was faster and more permanent.
The combined approach can be considered a cost-effective, safe and minimally-invasive treatment for epitrochleitis.
A Combined Ultrasound (US)-guided Percutaneous Treatment of Epitrochleitis: 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/2011/11011433.html