Preliminary results of colour Doppler-guided intratendinous glucocorticoid injection for Achilles tendonitis in five patients.
BACKGROUND
It is debated as to whether Achilles tendonitis (AT) has an inflammatory component. The intratendinous hyperaemia demonstrated with colour Doppler has been interpreted as neovascularisation. Glucocorticoid injection around the tendon is a common therapeutic procedure.


OBJECTIVE
The intratendinous hyperaemia seen with ultrasound (US) colour Doppler represents an inflammatory background. Glucocorticoid injections will be effective if administered inside the tendon where the inflammation seems to be.


METHODS
An uncontrolled, prospective study with a minimum follow-up of 3 months.


METHODS
Six tendons in five patients were evaluated with grey-scale US and colour Doppler before and after US-guided intratendinous glucocorticoid injection. Pain at rest and at activity was evaluated on a visual analogue scale.


RESULTS
With colour Doppler all tendons had intratendinous flow. Pain and colour Doppler activity decreased during a mean follow-up of 182 days (range 92-309 days). One tendon relapsed after 199 days.


CONCLUSIONS
Intratendinous glucocorticoid injections seem to have a marked effect on both symptoms and colour Doppler findings, which may be taken as an indication of an inflammatory component in the disease. Colour Doppler adds significant information to grey-scale US with regard to diagnosis, location and follow-up of AT.
Koenig
M J
MJ
The Parker Institute, Department of Rheumatology, Frederiksberg Hospital, Frederiksberg, Denmark.
Torp-Pedersen
S
S
Qvistgaard
E
E
Terslev
L
L
Bliddal
H
H
D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004338:Drug Combinations; D004360:Drug Therapy, Computer-Assisted / Q000379:methods; D018618:Echocardiography, Doppler, Color; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D052256:Tendinopathy / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000503:physiopathology
D004338:Drug Combinations; D005938:Glucocorticoids; D008012:Lidocaine; D008775:Methylprednisolone