Ultrasound-guided treatments for chronic Achilles tendinopathy: an update and current status.
Minimally-invasive treatments for chronic Achilles tendinopathy may prevent the need for surgery when conservative methods have failed. Whilst injections have traditionally been used to manage symptoms, recently described therapies may also have disease-modifying potential. Ultrasound provides the ability to guide therapeutic interventions, ensuring that treatment is delivered to the exact site of pathology. Treatments can be broadly categorised according to their intended therapeutic targets, although some may act through several possible mechanisms. In this article, we review the ultrasound-guided techniques currently used to treat chronic Achilles tendinopathy, with reference to the available literature. There is strong pilot-level evidence supporting the use of many of these techniques, although large definitive trials are lacking. An approach towards the management of chronic Achilles tendinopathy is suggested.
Wijesekera
Nevin T
NT
Department of Radiology, Chelsea and Westminster Hospital, 369 Fulham Road, London SW109NH, UK.
Chew
Ne Siang
NS
Lee
Justin C
JC
Mitchell
Adam W
AW
Calder
James D
JD
Healy
Jeremiah C
JC
D000125:Achilles Tendon / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D004564:Electrocoagulation / Q000379:methods / Q000639:trends; D005260:Female; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D008297:Male; D008875:Middle Aged; D012597:Sclerosing Solutions / Q000008:administration & dosage; D025321:Surgery, Computer-Assisted / Q000379:methods* / Q000639:trends; D052256:Tendinopathy / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D014463:Ultrasonography / Q000379:methods / Q000639:trends; D018084:Ultrasonography, Interventional / Q000379:methods* / Q000639:trends
D000893:Anti-Inflammatory Agents; D012597:Sclerosing Solutions