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A two-year sonographic follow-up after intratendinous injection therapy in patients with tennis elbow
  1. E Zeisig1,
  2. M Fahlström1,2,
  3. L Öhberg3,
  4. H Alfredson1
  1. 1Department of Surgical and Perioperative Science, Sports Medicine, University of Umeå, S-901 87 Umeå, Sweden
  2. 2Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, University of Umeå, Umeå, Sweden
  3. 3Department of Radiation Sciences, Diagnostic Radiology, University of Umeå, Umeå, Sweden
  1. Correspondence to Dr E Zeisig, Sports Medicine Unit, Department of Surgical and Perioperative Science, University of Umeå, 901 87 Umeå, Sweden; eva.zeisig{at}


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 intratendinous injections.

Design Follow-up study

Setting Sports Medicine Unit, Umeå University.

Patients 25 patients (28 elbows), mean age 46 years (range 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 two 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 two-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 intratendinous injection treatment of tennis elbow.

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  • Funding This study has been funded by the Swedish Research Council for Sports.

  • Competing interests None.

  • Ethics approval This study was approved by the Ethical Committee of the Medical Faculty, University of Umeå, Umeå, Sweden.