Department of Orthopaedic Surgery, School of Medicine, Chosun University Hospital, 588 Seosuk-Dong, Dong-Gu, Gwangju, 501-717, Republic of Korea.
Knee Surg Sports Traumatol Arthrosc. 2010 Jun;18(6):836-9. doi: 10.1007/s00167-009-1037-0. Epub 2010 Jan 29.
The purpose of this study is to evaluate the hypothesis that ultrasonographic probe-induced tenderness is a useful adjunct to the simple sonography in confirming the location of the pathology within the extensor carpi radialis brevis tendon in patients with lateral epicondylitis of the elbow. We conducted a case controlled study by evaluating 27 consecutive patients in the age group of 37-59 years (median 44) who had typical symptoms of lateral epicondylitis and a visual analogue score of more than 4 and evaluating a same number of asymptomatic healthy volunteers in the age group of 37-59 years (median 43) by means of ultrasound examination of the lateral elbow in a period of 5 months from 2007 to 2008. When we identified sonographic anechoic or hypoechoic lesions within the common extensor tendon we compressed it with the ultrasound probe to elicit tenderness so as to confirm the site of lesion within the affected tendon. We observed that the abnormal lesion detected by ultrasonography corresponded to the point of maximal tenderness when compressed by the probe in all the symptomatic patients. We therefore conclude that as it is essential to accurately detect the lesion within the extensor carpi radialis brevis for the purpose of diagnosis and treatment of lateral epicondylitis of elbow the technique of inducing tenderness at site of abnormal shadow on ultrasound within the extensor carpi radialis brevis tendon improves the accuracy of identifying the site of lesion, prevents the misinterpretation of anisotropy as pathological lesion and also can be useful to maximize the efficacy of interventions aimed in treating the lateral epicondylitis.
本研究旨在验证以下假设，即超声探头引起的压痛是一种有用的辅助手段，可与简单的超声检查结合使用，以确认肘部外侧上髁炎患者伸肌总腱桡侧短头腱内病变的位置。我们通过评估 2007 年至 2008 年 5 个月期间的 27 例连续患者（年龄组 37-59 岁，中位数 44 岁）和年龄组相同数量的无症状健康志愿者（37-59 岁，中位数 43 岁）进行了病例对照研究，这些患者具有典型的外侧上髁炎症状，视觉模拟评分超过 4 分，并通过超声检查评估了外侧肘部。当我们在伸肌总腱内发现无回声或低回声病变时，我们用超声探头压迫它以引起压痛，从而确认病变部位在受累的肌腱内。我们观察到，在所有有症状的患者中，超声检查发现的异常病变在被探头压迫时与压痛的最痛点相对应。因此，我们得出结论，由于准确检测伸肌总腱桡侧短头腱内的病变对于诊断和治疗肘部外侧上髁炎至关重要，因此在伸肌总腱桡侧短头腱内超声异常阴影部位引起压痛的技术可提高识别病变部位的准确性，防止将各向异性误诊为病变部位，并有助于最大限度地提高治疗外侧上髁炎的干预措施的疗效。
