Purpose of Review
The purpose of the study was to review the efficacy and safety of common ultrasound-guided injections for tendinopathy conditions. Corticosteroid injections have historically been the most common injection used for tendinopathy; however, there are an increasing number of injections including platelet-rich plasma, hyaluronan, polidocanol, botulinum toxin, and high volume saline injections.
There is growing evidence that while corticosteroid injections for tendinopathies usually have short-term efficacy, they may result in medium-term harm, particularly for tennis elbow (lateral epicondylitis). Corticosteroid injections appear to have more clinical utility for tenosynovitis conditions. There is insufficient evidence regarding other injection options to make a broad recommendation in favour, although individual trials for certain tendons illustrate benefits for some of the non-corticosteroid options.
When considering the use of ultrasound-guided corticosteroid injections for tendinopathies, the risk of possible medium-term harm must be weighed up against any short-term efficacy. Other injection-based therapies may be appropriate in certain clinical situations; however, the evidence and clinical circumstances must be considered for the particular tendon and patient. Load-based rehabilitation remains the cornerstone of tendinopathy management.
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Conflict of interest
John W. Orchard, Richard Saw, and Lorenzo Masci each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
None of the images illustrated in this study were obtained from live patients where consent would have been required (either cadaver models or self-images of the authors were used for all Figures).
This article is part of the Topical collection on Sports Imaging.
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Orchard, J.W., Saw, R. & Masci, L. The Use of Ultrasound-Guided Injections for Tendinopathies. Curr Radiol Rep 6, 38 (2018). https://doi.org/10.1007/s40134-018-0296-2