L Öhberg, H Alfredson, K M Khan

Ultrasound guided sclerosis of neovessels in painful chronic Achilles tendinosis: pilot study of a new treatment • Commentary
Br J Sports Med 2002; 36: 173-175 [Abstract] [Full text] [PDF]

hindoma{at}yahoo.com Mahamoud M Gabal

I read with interest this work..But from the radiological point of view the in line technique for injection is much effective for attacking the color spots which represent the neovessls. There are two types for this technique.First the long in line technique which enable us to see the entire path of the needle in its way to attack the target. We inject from the medial side in the direction of the long axis of the tendon with a shallow angle to attack several spots. The injection is done during withdrawal of the needle. Here the position of the probe is identical to the figure 1. In short line technique the probe is perpendicular to the short axis of the tendon. And the needle is at a shallow angle to the probe. The injection also is done from the medial side. We see the distal part of the needle attacking the target. The needle in the perpendicular plain to the tendon and to the long axis of the probe will appear as an echogenic dot with posterior artifact. This echogenic dot will appear after a certain distance from the edge of the probe. We cannot accurately know whether it is inside the color spot or, before or after it at the same plain .The immediate disappearance of the color spots may be simply from pressure of our material on the vessels not to it's direct effect on it. . so the in-line technique is more accurate and enables us to directly attack multiple colour spots with one injection.....Thanks