Ultrasound-guided, minimally invasive, percutaneous needle puncture treatment for tennis elbow.
BACKGROUND
This report evaluates the efficacy of percutaneous needle puncture under sonographic guidance in treating lateral epicondylitis (tennis-elbow).


METHODS
Ultrasound-guided percutaneous needle puncture was performed on 76 patients who presented with persistent elbow pain. Under a local anesthetic and sonographic guidance, a needle was advanced into the calcification foci and the calcifications were mechanically fragmented. This was followed by a local injection of 25 mg prednisone acetate and 1% lidocaine. If no calcification was found then multiple punctures were performed followed by local injection of 25 mg prednisone acetate and 1% lidocaine. A visual analog scale (VAS) was used to evaluate the degree of pain pre-and posttreatment at 1 week to 24 weeks. Elbow function improvement and degree of self-satisfaction were also evaluated.


RESULTS
Of the 76 patients, 55% were rated with excellent treatment outcome, 32% good, 11% average, and 3% poor. From 3 weeks posttreatment, VAS scores were significantly reduced compared with the pretreatment score (P<0.05) and continued to gradually decline up to 24 weeks posttreatment. Sonography demonstrated that the calcified lesions disappeared completely in 13% of the patients, were reduced in 61% of the patients, and did not change in 26% of the patients. Color Doppler flow signal used to assess hemodynamic changes showed a significant improvement after treatment in most patients.


CONCLUSIONS
Ultrasound-guided percutaneous needle puncture is an effective and minimally invasive treatment for tennis elbow. Sonography can be used to accurately identify the puncture location and monitor changes.
Zhu
Jiaan
J
Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. zhujiaan70@hotmail.com
Hu
Bing
B
Xing
Chunyan
C
Li
Jia
J
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000627:therapeutic use; D002114:Calcinosis / Q000601:surgery; D004551:Elbow Joint / Q000000981:diagnostic imaging*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D019637:Orthopedic Procedures; D010147:Pain Measurement; D017060:Patient Satisfaction; D011241:Prednisone / Q000627:therapeutic use; D013716:Tennis Elbow / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D014463:Ultrasonography; D055815:Young Adult
D000779:Anesthetics, Local; D005938:Glucocorticoids; D008012:Lidocaine; D011241:Prednisone