Journals / Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi / 2024 / Volume: 38 Issue: 3

THE RELATIONSHIP BETWEEN CLINICAL AND ULTRASOUND FINDINGS AND CHANGES IN TREATMENT IN PATIENTS WITH LATERAL EPISCONDYLITIS: 6-MONTH RESULTS

LATERAL EPİKONDİLİT TANILI HASTALARDA KLİNİK VE ULTRASONOGRAFİK BULGULAR İLE TEDAVİ DEĞİŞİMİ ARASINDAKİ İLİŞKİ: 6 AYLIK SONUÇLAR

Banu Dilek(Dokuz Eylül Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı)0000-0002-5451-0757
Kadir Songür(Hatay Dörtyol Devlet Hastanesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı)0000-0002-8797-4195
Nihan Erdinç Gündüz(Dokuz Eylül Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı)0000-0002-0371-328X
Hülya Ellidokuz(Dokuz Eylül Üniversitesi Tıp Fakültesi Prevantif Onkoloji Anabilim Dalı)0000-0001-8503-061X
Onur Başçı(Dokuz Eylül Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı)0000-0003-1689-0346
Selmin Gülbahar(Dokuz Eylül Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı)0000-0003-1376-773X
Mustafa Hulusi Özkan(Dokuz Eylül Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı)0000-0003-1097-6608
Pages
251–262
Publication Date
2024-12-27
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Discussion and Conclusion It was found that the main parameters contributing to the need for conservative treatment changes in patients with lateral epicondylitis during a six-month follow-up were only VAS (rest, night and activity) and PRTEE total scores.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective The aim of this study was to determine the relationship between clinical findings, ultrasonographic evaluations, and treatment changes in the long-term follow-up of patients treated for lateral epicondylitis.
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Key Findings & Data:Method The files of 30 patients diagnosed with lateral epicondylitis, who met the inclusion and exclusion criteria and were followed for at least 6 months, were retrospectively reviewed.
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Conclusion & Impact:Discussion and Conclusion It was found that the main parameters contributing to the need for conservative treatment changes in patients with lateral epicondylitis during a six-month follow-up were only VAS (rest, night and activity) and PRTEE total scores.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:lateral epikondilit · ultrasonografi · konservatif tedavi

Abstract

Objective The aim of this study was to determine the relationship between clinical findings, ultrasonographic evaluations, and treatment changes in the long-term follow-up of patients treated for lateral epicondylitis. Method The files of 30 patients diagnosed with lateral epicondylitis, who met the inclusion and exclusion criteria and were followed for at least 6 months, were retrospectively reviewed. The demographic characteristics of the patients, as well as pain-function assessment scales, grip strength values, and ultrasonographic evaluations routinely performed during outpatient follow-up and recorded in patient files, were examined and recorded. Visual Analog Scale (VAS 0-10 cm) scores, algometric measurements, dynamometric measurements, Nirschl scores, Patient-Rated Tennis Elbow Evaluation (PRTEE) scores, maximum tendon thickness measurements in the capitellar region, and Total Ultrasonography Scale scores were used as patient evaluation parameters. The presence of treatment changes (such as application of ESWT, steroid injection, PRP injection, etc., for those who did not respond to splint and exercise) was also evaluated. All parameter values before treatment, at 1 month, 3 months, and 6 months post-treatment were recorded. Results Data from 21 female and 9 male patients, with an average age of 49.1±9.2 years, who were followed for at least 6 months with a diagnosis of lateral epicondylitis were evaluated. The average symptom duration of the patients was 3.7±4.2 months. Significant improvement was observed in the clinical and ultrasonographic evaluation criteria of all patients at the end of the 6-month follow-up (p 0.05). The VAS-rest, VAS-night, VAS-activity, and PRTEE-total scores of those with treatment changes were significantly higher compared to those without treatment changes (p=0.014, p=0.02, p= 0.05). Discussion and Conclusion It was found that the main parameters contributing to the need for conservative treatment changes in patients with lateral epicondylitis during a six-month follow-up were only VAS (rest, night and activity) and PRTEE total scores.

Özet

Amaç Bu çalışmada; lateral epikondilit tedavisinin uzun dönem izleminde hastaların klinik bulgularının, ultrasonografik değerlendirmelerinin ve tedavi değişimlerinin arasındaki ilişkinin belirlenmesi amaçlanmıştır. Yöntem Çalışmaya dahil edilme ve dışlanma kriterlerini karşılayan ve en az 6 ay boyunca takip edilmiş olan 30 lateral epikondilit tanılı hastaların dosyaları retrospektif olarak incelenmiştir. Hastaların demografik özellikleri ile poliklinik izleminde rutin olarak yapılan ve hasta dosyalarına kaydedilmiş olan ağrı-fonksiyon değerlendirme ölçekleri, el sıkma kuvveti değerleri ve ultrasonografik değerlendirmeleri incelenmiş ve kaydedilmiştir. Visual analog skala (VAS) skorları, algometrik ölçümler, dinamometrik ölçümler, Nirschl skoru, Hasta bazlı tenisçi dirseği değerlendirme anketi (PRTEE) skorları, kapitellar bölge maksimum tendon kalınlığı ölçümleri ve total ultrasonografi skalası skorlamaları; hasta değerlendirme parametreleri olarak kullanılmıştır. Hastalarda değişim yapılan tedavi varlığı (atel ve egzersiz yanıtı olmamış ve ESWT, steroid enjeksiyonu, PRP enjeksiyonu vb. tedavilerin uygulandığı) da değerlendirilmiştir. Hastaların tedavi öncesi, tedavi sonrası 1. ay, 3. ay ve 6. ayındaki tüm parametrelerindeki değerler kayıtlanmıştır. Bulgular En az 6 ay boyunca lateral epikondilit tanısıyla takip edilmiş, yaş ortalaması 49.1±9.2 olan 21 kadın ve 9 erkek hastanın verileri değerlendirildi. Hastaların ortalama semptom süresi 3.7±4.2 aydı. Çalışmaya alınan tüm hastaların klinik ve ultrasonografik değerlendirme ölçütlerinde 6 aylık takip sonunda belirgin iyileşme saptandı (p 0.05). Tedavi değişimi olanların VAS-istirahat, VAS-Gece, VAS-aktivite ve PRTEE-total skorları tedavi değişimi olmayanlara göre anlamlı olarak yüksekti (sırasıyla p=0.014, p=0.02, p= 0.05). Tartışma ve Sonuç Lateral epikondilitli hastalarda altı aylık takipte konservatif tedavi değişimine katkıda bulunan temel parametrelerin yalnızca VAS (istirahat, gece ve aktivite) ve PRTEE total skorları olduğu bulunmuştur.

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Cite This Article

Dilek, B., Songür, K., Gündüz, N. E., Ellidokuz, H., Başçı, O., Gülbahar, S., Özkan, M. H. (2024). THE RELATIONSHIP BETWEEN CLINICAL AND ULTRASOUND FINDINGS AND CHANGES IN TREATMENT IN PATIENTS WITH LATERAL EPISCONDYLITIS: 6-MONTH RESULTS. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi, Volume: 38 Issue: 3, 251–262. https://doi.org/10.18614/deutip.1525219

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References (23)

  1. Miller T, Shapiro M, Schultz E, Kalish PE. Comparison of sonography and MRI for diagnosing epicondylitis. J Clin Ultrasound 2002;30:193–202.
  2. Levin D, Nazarian L, Miller T, et al. Lateral Epicondylitis of the Elbow: US Findings. Radiology. 2005;237(1):230-234. doi:10.1148/radiol.2371040784
  3. Capan N, Esmaeilzadeh S, Oral A, Basoglu C, Karan A, Sindel D. Radial extracorporeal shock wave therapy is not more effective than placebo in the management of lateral epicondylitis: a double-blind, randomized, placebo-controlled trial. Am J Phys Med Rehabil 2016;95:495-506. https://doi.org/10.1097/PHM.0000000000000407.
  4. Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M. Prevalence and determinants of lateral and medial epicondylitis: A population study. Am J Epidemiol. 2006;164(11):1065-1074. doi:10.1093/AJE/KWJ325.
  5. Trudel D, Duley J, Zastrow I, Kerr EW et al. Rehabilitation for patients with lateral epicondylitis: A systematic review. J Hand Ther. 2004; 17: 243-66.
  6. Bishai S, Plancher K. The Basic Science of Lateral Epicondylosis: Update for the Future. Techniques in Orthopaedics. 2006;21(4):250-255. doi:10.1097/01.bto.0000252115.76643.78.
  7. Kannus P, Józsa L. Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am. 1991;73(10):1507-1525.
  8. Doran A, Gresham G, Rushton N, Watson C. Tennis elbow. A clinicopathologic study of 22 cases followed for 2 years. Acta Orthop Scand. 1990;61(6):535-538. doi:10.3109/17453679008993577.
  9. Rudi Dingemanse, Manon Randsdorp, Bart W Koes, Bionka M A Huisstede Evidence for the effectiveness of electrophysical modalities for treatment of medial and lateral epicondylitis: a systematic review. Br J Sports Med 2014; 48:957–965. doi:10.1136/bjsports-2012-091513.
  10. Scher D, Wolf J, Owens B. Lateral epicondylitis. Orthopedics. 2009;32(4).
  11. Connell D, Burke F, Coombes P, et al. Sonographic Examination of Lateral Epicondylitis. American Journal of Roentgenology. 2001;176(3):777-782. doi:10.2214/ajr.176.3.1760777.
  12. Clarke AW, Ahmad M, Curtis M, Connell DA. Lateral elbow tendinopathy: Correlation of ultrasound findings with pain and functional disability. American Journal of Sports Medicine. 2010;38(6). doi:10.1177/0363546509359066.
  13. Assendelft W, Green S, Buchbinder R, Struijs P, Smidt N. Tennis elbow. BMJ. 2003;327(7410):329. doi:10.1136/bmj.327.7410.329.
  14. Du Toit C, Stieler M, Saunders R, Bisset L, Vicenzino B. Diagnostic accuracy of power Doppler ultrasound in patients with chronic tennis elbow. Br J Sports Med. 2008;42(11):572-576. doi:10.1136/bjsm.2007.043901
  15. Heales L, Broadhurst N, Mellor R, Hodges P, Vicenzino B. Diagnostic Ultrasound Imaging for Lateral Epicondylalgia. Med Sci Sports Exerc. 2014;46(11):2070-2076. doi:10.1249/MSS.0000000000000345
  16. Krogh T, Fredberg U, Christensen R, Stengaard-Pedersen K, Ellingsen T. Ultrasonographic Assessment of Tendon Thickness, Doppler Activity and Bony Spurs of the Elbow in Patients with Lateral Epicondylitis and Healthy Subjects: A Reliability and Agreement Study. Ultraschall in der Medizin - European Journal of Ultrasound. 2013;34(05):468-474. doi:10.1055/s-0033-1335951.
  17. Palaniswamy V, Ng S, Manickaraj N, et al. Relationship between ultrasound detected tendon abnormalities, and sensory and clinical characteristics in people with chronic lateral epicondylalgia. PLoS One. 2018;13(10):e0205171. doi:10.1371/journal.pone.0205171.
  18. Kraushaar BS, Nirschl RP. Tendinosis of the elbow (tennis elbow). Clinical features and findings of histological, immunohistochemical, and electron microscopy studies. J Bone Joint Surg Am. 1999;81(2):259-278.
  19. Altan L, Ercan I, Konur S. Reliability and validity of Turkish version of the patient-rated tennis elbow evaluation. Rheumatol Int. 2010;30(8). doi:10.1007/s00296-009-1101-6.
  20. Sadeghi-Demneh E and Jafarian F. The immediate effects of orthoses on pain in people with lateral epicondylalgia. Pain Res Treat 2013; 2013: 353597.
  21. Zeisig E, Fahlström M, Ohberg L, Alfredson H. A two-year sonographic follow-up after intratendinous injection therapy in patients with tennis elbow. Br J Sports Med. 2010 Jun;44(8):584-7.
  22. Krogh TP, Fredberg U, Stengaard-Pedersen K, Christensen R, Jensen P, Ellingsen T. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: a randomized, double-blind, placebo-controlled trial. Am J Sports Med. 2013 Mar;41(3):625-35.
  23. Gündüz R, Malas FÜ, Borman P, Kocaoğlu S, Özçakar L. Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis. Clinical and ultrasonographical comparison. Clin Rheumatol. 2012 May;31(5):807-12.