Measurement issues in the sonographic assessment of tennis elbow

Abstract

Sonography is increasingly being used for assessment in tennis elbow research and clinical practice, but there are a lack of data regarding its validity, reliability, and responsiveness to change for this application. Studies using the modality were reviewed to establish current levels of evidence for these measurement properties. There is reasonable evidence regarding its validity for identifying tennis elbow tendinopathy, but a lack of data addressing its reliability and responsiveness. Practical issues affecting image quality are discussed, and recommendations for further investigation are suggested, to enhance the credible use of sonography with this debilitating condition.

Ultrasonographic Characteristics of the Common Extensor Tendon of the Elbow in Asymptomatic Individuals: Thickness, Color Doppler Activity, and Bony Spurs

“…26,32,35 In many studies investigating LE with the use of US, the presence of spurs is described as a sonographic characteristic of tendinopathy. 8,22,29,30 Bony spurs might occur with a higher prevalence or size in patients with LE. However, based on the findings in our study, the clinical value of describing a bony spur is limited because it is a very common phenomenon.…”

“…1,17,24,40 Several studies have adopted some of these US features in the assessment of patients with LE. 4,5,22,23,25,29 However, the described tendinopathic changes have not been compared with those present in the general population, and the standards lack a scientifically based consensus. The establishment of valid standards will help to avoid misinterpretation and distinguish between pathological and benign US findings.…”

Treatment of Lateral Epicondylitis With Platelet-Rich Plasma, Glucocorticoid, or Saline

“…1,27,33,61 Several studies have described these US features in patients with LE. 7,30,32,36,48 Our objective was to determine whether 1 injection of PRP or glucocorticoid reduces pain more effectively than isotonic saline in adults with LE.…”

Dynamic weight bearing analysis is effective for evaluation of tendinopathy using a customized corridor with multi-directional force sensors in a rat model

“…Blood vessels are seldom visible inside a healthy endotendon. Although neovascularization in ultrasound imaging is not always revealed in every tendinopathic tendon, it is still regarded as a hallmark of tendinopathy 19 . We found that all ultrasound features had higher scores in the Collagenase group than in the Control group, except for calcification at weeks 1 and 4 .…”