Giulio Ferrero, Presenter: Nothing to Disclose

Chiara Martini MChir, Abstract Co-Author: Nothing to Disclose

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

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

Giacomo Garlaschi MD, Abstract Co-Author: Nothing to Disclose

A combined US-guided percutaneous treatment of lateral epicondylitis, based on dry needling and local steroid injection, has already been described but no data are available regarding its imaging follow-up. Our purpose was to evaluate the imaging appearance of the CET in patients who underwent US-guided percutaneous treatment of lateral epicondylitis, correlating those findings with clinical outcome.

IRB approval and informed consent were obtained. We studied 40 patients (26 males, 14 females, mean age 48±7.4) suffering from lateral epicondilytis, who underwent to an US-guided percutaneous treatment. A visual analogue scale (VAS from 0 to 10) was used to evaluate the degree of pain at baseline and at 2, 12, 36 and 48 weeks after the procedure. US, real-time sonoelastography and color-Doppler were performed at baseline and at 2,12, 36 and 48 weeks after the treatment. Sonoelastographic findings were converted into a semi-quantitative score (blue to red, from 1 to 5, respectively). Color-Doppler findings were translated into a semiquantitative score (grade 0= normal, grade 1=slight, grade 2=moderate, grade 3=marked). Wilcoxon and Kruskall-Wallis tests were used.

Patients treated had a fast and permanent decrease of symptoms (VAS at baseline=7.2±0.9, VAS at 2 weeks=2.5±0.4, VAS at 12 weeks=1.5±0.6 , VAS at 36 weeks=1.0±0.64 and VAS at 48 weeks=0.0± 0.4; p<.01 for all compared to baseline). Real-time sonoelastography values were 4; 2-5 (median; 25th-75th percentiles) at baseline, 4; 3-5 after 2 weeks, 3; 2-4 after 12 weeks, 1; 1-3 after 36 weeks, and 1; 1-2 after 48 weeks. Color-Doppler values were 3; 2-3, 3;2-3, 2;2-3, 0;0-2; 0;0-1, respectively. High correlation was found between VAS scale in respect to real-time sonoelastography (r=.818) or color-Doppler (r=.849).

Real-time sonoelastography and color-Doppler are effective in assessing pre- and post-treatment CET damage with high correlation to clinical symptoms.

Real-time sonoelastography and color-Doppler can be effectively used in the follow-up of patients treated for lateral epicondylitis using an US-guided percutaneous treatment.

Ferrero, G, Martini, C, Sconfienza, L, Silvestri, E, Garlaschi, G, Real-time Sonoelastography and Color-Doppler Ultrasound (US) Evaluation of the Common Extensor Tendon (CET) after US-guided Treatment of Lateral Epicondylitis.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034301.html