Koenig M J, Torp-Pedersen S, Qvistgaard E, Terslev L, Bliddal H
The Parker Institute, Department of Rheumatology, Frederiksberg Hospital, Frederiksberg, Denmark.
Scand J Med Sci Sports. 2004 Apr;14(2):100-6. doi: 10.1046/j.1600-0838.2003.00364.x.
It is debated as to whether Achilles tendonitis (AT) has an inflammatory component. The intratendinous hyperaemia demonstrated with colour Doppler has been interpreted as neovascularisation. Glucocorticoid injection around the tendon is a common therapeutic procedure.
The intratendinous hyperaemia seen with ultrasound (US) colour Doppler represents an inflammatory background. Glucocorticoid injections will be effective if administered inside the tendon where the inflammation seems to be.
An uncontrolled, prospective study with a minimum follow-up of 3 months.
Six tendons in five patients were evaluated with grey-scale US and colour Doppler before and after US-guided intratendinous glucocorticoid injection. Pain at rest and at activity was evaluated on a visual analogue scale.
With colour Doppler all tendons had intratendinous flow. Pain and colour Doppler activity decreased during a mean follow-up of 182 days (range 92-309 days). One tendon relapsed after 199 days.
Intratendinous glucocorticoid injections seem to have a marked effect on both symptoms and colour Doppler findings, which may be taken as an indication of an inflammatory component in the disease. Colour Doppler adds significant information to grey-scale US with regard to diagnosis, location and follow-up of AT.
跟腱炎（AT）是否存在炎症成分存在争议。彩色多普勒显示的腱内充血已被解释为新生血管形成。在肌腱周围注射糖皮质激素是一种常见的治疗方法。
超声（US）彩色多普勒显示的腱内充血代表炎症背景。如果在似乎存在炎症的肌腱内部注射糖皮质激素，将会有效。
一项非对照前瞻性研究，最短随访3个月。
在超声引导下进行腱内糖皮质激素注射前后，对5例患者的6条肌腱进行灰阶超声和彩色多普勒评估。采用视觉模拟量表评估静息和活动时的疼痛情况。
彩色多普勒显示所有肌腱均有腱内血流。在平均182天（92 - 309天）的随访期间，疼痛和彩色多普勒活动度降低。1条肌腱在199天后复发。
腱内注射糖皮质激素似乎对症状和彩色多普勒检查结果均有显著影响，这可能表明该疾病存在炎症成分。在跟腱炎的诊断、定位和随访方面，彩色多普勒为灰阶超声增添了重要信息。
