Department of Arthroscopic and Shoulder Surgery, Metropolitan General Hospital, Athens, Greece.
Department of Sports Medicine & Exercise Biology, School of Physical Education and Sport Science, National and Kapodistrian, University of Athens, Athens, Greece.
Skeletal Radiol. 2020 Apr;49(4):585-591. doi: 10.1007/s00256-019-03315-9. Epub 2019 Nov 12.
To compare accuracy, patient discomfort, and clinical outcome of ultrasound-guided versus palpation-guided corticosteroid injections to the bicipital groove in patients with long head of biceps (LHB) tendinosis.
Forty-four patients with primary LHB tendinosis were randomized into two groups (group A, n = 22; group B, n = 22). All patients underwent treatment with a single corticosteroid injection to the bicipital groove. Injections in group A were performed under ultrasound-guidance, while in group B using a palpation-guided technique. The duration of each procedure was recorded. To assess accuracy, ultrasound examination was performed in both groups after injection. Patient discomfort was evaluated with visual analogue scale (VAS) for pain. The clinical outcome was assessed comparing the VAS, the Single Assessment Numeric Evaluation (SANE) score and the QuickDASH score before treatment and after 4 weeks and 6 months.
The mean duration of the procedure was 64 ± 6.87 s in group A and 81.91 ± 8.42 s in group B (p < 0.001). Injection accuracy in group A was 100% and in group B 68.18%. Discomfort was lower in group A, as compared to group B (22.10 vs. 35.50; p < 0.001). Symptoms, as measured by VAS, SANE and QuickDASH scores, improved in both groups at 4 weeks and 6 months (p < 0.05). Superior clinical improvement was recorded in group A in both time points (p < 0.05).
Corticosteroid injections are an effective treatment for primary LHB tendinosis. Under ultrasound guidance, injections to the bicipital groove are faster and produce lower discomfort. Superior accuracy and clinical outcomes can be achieved using the ultrasound-guided technique.
Level II; Prospective Randomized Comparative Study.
比较超声引导与触诊引导肱二头肌长头肌腱病患者肱二头肌沟内皮质类固醇注射的准确性、患者不适和临床结果。
44 例原发性肱二头肌长头肌腱病患者随机分为两组（A 组，n=22；B 组，n=22）。所有患者均接受单次肱二头肌沟内皮质类固醇注射治疗。A 组注射在超声引导下进行，B 组采用触诊引导技术。记录每个程序的持续时间。为了评估准确性，在注射后对两组均进行超声检查。使用视觉模拟量表（VAS）评估患者疼痛时的不适程度。在治疗前、4 周和 6 个月时，通过 VAS、单一评估数字评估（SANE）评分和快速残疾状况量表（QuickDASH）评分比较评估临床结果。
A 组手术时间平均为 64±6.87 秒，B 组为 81.91±8.42 秒（p<0.001）。A 组注射准确率为 100%，B 组为 68.18%。与 B 组相比，A 组的不适感较低（22.10 对 35.50；p<0.001）。两组在 4 周和 6 个月时 VAS、SANE 和 QuickDASH 评分均有所改善（p<0.05）。在两个时间点，A 组的临床改善均更为显著（p<0.05）。
皮质类固醇注射是治疗原发性肱二头肌长头肌腱病的有效方法。在超声引导下，向肱二头肌沟内注射速度更快，不适感更低。超声引导技术可实现更高的准确性和临床效果。
II 级；前瞻性随机对照研究。
