Sonographic-guided injection of corticosteroid in the treatment of lateral epicondylitis
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2009
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Abstract
Objective: In this study the advantage of ultrasonography [US] in diagnosis and therapy of lateral epicondylitis [LE] was investigated in patients with lateral elbow pain and clinically diagnosed as LE. Methods: Fifty-two patients with LE were examined using sonography. For the patients in whom normal US examination was found, a blind injection of methylprednisolone 20 mg and 0.5 ml one percent lignocaine was performed [Group 1]. The patients whose clinical diagnosis was confirmed with US received a sonographic-guided injection of methylprednisolone 20 mg and 0.5 ml one percent lignocaine [Group 2]. Outcome measurements were performed at baseline, two weeks, one month, and three months. Pain and functional status were assessed using a visual analog scale, physical functioning and bodily pain scales of the Medical Outcomes Study 36 Item Short-Form Health Survey, a patient-rated forearm evaluation questionnaire, and a patient-specific functional scale. Painless grip strength bilaterally was also measured. Results: Twenty-four [46.2 percent] patients had a normal-appearing common extensor origin on US. The group in which diagnosis of LE was confirmed on US and sonographic-guided corticosteroid injections improved significantly from the baseline to the third month follow up [P < 0.000] in both clinical assessment and physical examination findings. Conclusions: Our case series suggested that sonography of the common extensor origin can be used to confirm LE in patients with lateral elbow pain. Although sonographic-guided injections produced more clinical improvement, further studies are needed to determine effectiveness of sonographic-guided injections. © 2009 by Informa Healthcare USA, Inc. All rights reserved.