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A 2-year sonographic follow-up after intratendinous injection therapy in patients with tennis elbow
  1. Eva Ch L Zeisig (eva.zeisig{at}
  1. Department of Surgical and Perioperative Science, Sports Medicine, Umeå University, S-901 87 Umeå, Sweden
    1. Martin Fahlström (martin.fahlstrom{at}
    1. Department of Surgical and Perioperative Science, Sports Medicine, Umeå University, S-901 87 Umeå, Sweden
      1. Lars Öhberg (lars.ohberg{at}
      1. Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Sweden
        1. Hakan Alfredson (hakan.alfredson{at}
        1. Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Sweden


          Background: Tennis elbow is a tendinopathy affecting the upper extremity. Recent studies have shown high sensitivity for ultrasound (US) examination and high specificity for colour Doppler (CD) examination. There are no mid- or long-term follow-up investigations of the tendon structure and blood flow using these techniques.

          Objective: To use US and CD to study structure and blood flow in the extensor origin in patients with tennis elbow treated with intra-tendinous injections.

          Design: Follow-up study.

          Setting: Sports Medicine Unit, Umeå University.

          Patients: Twenty-five patients (twenty-eight elbows), age 46 years (27-66), treated with intratendinous injections due to chronic pain from tennis elbow.

          Method: US- and CD-examination of the extensor origin was carried out at inclusion and at follow-up 2 years after intratendinous injection treatment with polidocanol and/or a local anaesthetic.

          Main outcome measurements: US (structure) and CD (blood flow) findings.

          Results: All patients had structural tendon changes and high blood flow at inclusion when given the injection treatment. At the 2-year follow up, structural tendon changes were seen in 20/28 elbows and high blood flow was seen in 4/28 elbows. The majority of patients with a good clinical result after treatment had no visible blood flow (17/20), but the structural changes showed no relation to a good result (13/20 remaining changes).

          Conclusions: Doppler findings, but not structure, might be related to the clinical result after intra-tendinous injection treatment of tennis elbow.

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