title: Ultrasound-Guided Fenestration of Tendons About the Hip and Pelvis: Clinical Outcomes.
abstract: OBJECTIVE
  Percutaneous ultrasound-guided needle fenestration has been used to treat tendinopathy of the elbow, knee, and ankle with promising results. The purpose of this study was to evaluate the clinical outcome of ultrasound-guided fenestration of tendons about the hip and pelvis.
  
  
  METHODS
  After Institutional Review Board approval, a retrospective search of imaging reports from January 1, 2005, to June 30, 2011, was completed to identify patients treated with ultrasound-guided tendon fenestration about the hip or pelvis. Subsequent clinic notes were retrospectively reviewed to determine whether the patient showed marked improvement, some improvement, no change, or worsening symptoms.
  
  
  RESULTS
  The study group consisted of 22 tendons in 21 patients with an average age of 55.8 years (range, 26.7-77.0 years). The treated tendons included 11 gluteus medius (9 tendinosis and 2 partial tears), 2 gluteus minimus (both tendinosis), 8 hamstring (6 tendinosis and 2 partial tears), and 1 tensor fascia latae (tendinosis). The average interval to clinical follow-up was 70 days (range, 7-813 days). There was marked improvement in 45.5% (10 of 22), some improvement in 36.4% (8 of 22), no change in symptoms in 9.1% (2 of 22), and worsening symptoms in 9.1% (2 of 22). There were no patient variables (age, chronicity of symptoms, sex, tendon, tendinosis versus tear, prior physical therapy, and prior corticosteroid injection) that were significantly different between patients who improved and those who did not. There were no cases of a subsequent tendon tear or infection.
  
  
  CONCLUSIONS
  Clinical follow-up after ultrasound-guided fenestration of the gluteus medius, gluteus minimus, proximal hamstring, and tensor fascia latae tendons showed that 82% of patients had improvement in their symptoms.
authors.affiliation: Department of Radiology (J.A.J., J.R., C.M.Y., S.M.K., M.K.-B.) and Michigan Institute for Clinical and Health Research (A.P.), University of Michigan, Ann Arbor, Michigan USA. jjacobsn@umich.edu.
authors.forename: Jon A
authors.initials: JA
authors.lastname: Jacobson
authors.affiliation: Department of Radiology (J.A.J., J.R., C.M.Y., S.M.K., M.K.-B.) and Michigan Institute for Clinical and Health Research (A.P.), University of Michigan, Ann Arbor, Michigan USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Rubin
authors.affiliation: Department of Radiology (J.A.J., J.R., C.M.Y., S.M.K., M.K.-B.) and Michigan Institute for Clinical and Health Research (A.P.), University of Michigan, Ann Arbor, Michigan USA.
authors.forename: Corrie M
authors.initials: CM
authors.lastname: Yablon
authors.affiliation: Department of Radiology (J.A.J., J.R., C.M.Y., S.M.K., M.K.-B.) and Michigan Institute for Clinical and Health Research (A.P.), University of Michigan, Ann Arbor, Michigan USA.
authors.forename: Sung Moon
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Radiology (J.A.J., J.R., C.M.Y., S.M.K., M.K.-B.) and Michigan Institute for Clinical and Health Research (A.P.), University of Michigan, Ann Arbor, Michigan USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Kalume-Brigido
authors.affiliation: Department of Radiology (J.A.J., J.R., C.M.Y., S.M.K., M.K.-B.) and Michigan Institute for Clinical and Health Research (A.P.), University of Michigan, Ann Arbor, Michigan USA.
authors.forename: Aishwarya
authors.initials: A
authors.lastname: Parameswaran
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006615:Hip / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D052256:Tendinopathy / Q000000981:diagnostic imaging* / Q000601:surgery*; D058971:Tenotomy / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
keywords: fenestration; musculoskeletal ultrasound; tendinopathy; tendinosis; tendon; tenotomy