Tenotomía percutánea ecoguiada en entesopatía crónica de extensores de muñeca / Ultrasound-guided percutaneous tenotomy in chronic wrist extensor enthesopathy

La epicondilitis es una entidad que provoca discapacidad y tiende a cronificar. Histológicamente, existen lesiones degenerativas en el tendón extensor común del antebrazo, visibles mediante ecografía o resonancia magnética. Existen diversas medidas terapéuticas conservadoras, incluida la infiltración con corticoide por referencia anatómica; pero en ocasiones fracasan, y los pacientes son propuestos para cirugía. La ecografía como herramienta terapéutica permite realizar procedimientos sin apertura cutánea sobre los tendones. En 2006, se publicó la realización de una tenotomía percutánea ecoguiada para el tratamiento de la epicondilitis crónica. La técnica, mostrada hasta ahora por cirujanos y radiólogos, intenta transformar un proceso degenerativo crónico con fallo en la reparación, en un proceso inflamatorio agudo con perspectivas de autorregeneración. Nuestro objetivo es describir 5 casos clínicos de epicondilitis con fracaso de las medidas terapéuticas habituales, en los que se realiza una tenotomía percutánea ecoguiada en la propia consulta, con resultados favorables

Epicondylitis causes disability and tends to become chronic. Histologically, degenerative lesions are found in the common extensor tendon, which are visible on ultrasound or magnetic resonance imaging. Several conservative therapeutic measures are available, including corticosteroid infiltration by anatomical landmark. However, these measures sometimes fail, in which case patients are proposed for surgery. Ultrasound is a therapeutic tool that allows procedures on tendons to be performed without skin incisions. The technique of ultrasound-guided percutaneous tenotomy for the treatment of chronic epicondylitis was first reported in 2006. This procedure, demonstrated to date by surgeons and radiologists, attempts to transform a chronic degenerative process with failure to repair into an acute inflammatory process with self-regeneration. The aim of this study was to describe 5 cases of epicondylitis that failed to respond to routine therapeutic measures, in which we used ultrasound-guided percutaneous tenotomy with favourable results

[Ultrasound-guided percutaneous tenotomy in chronic wrist extensor enthesopathy]. / Tenotomía percutánea ecoguiada en entesopatía crónica de extensores de muñeca.

Epicondylitis causes disability and tends to become chronic. Histologically, degenerative lesions are found in the common extensor tendon, which are visible on ultrasound or magnetic resonance imaging. Several conservative therapeutic measures are available, including corticosteroid infiltration by anatomical landmark. However, these measures sometimes fail, in which case patients are proposed for surgery. Ultrasound is a therapeutic tool that allows procedures on tendons to be performed without skin incisions. The technique of ultrasound-guided percutaneous tenotomy for the treatment of chronic epicondylitis was first reported in 2006. This procedure, demonstrated to date by surgeons and radiologists, attempts to transform a chronic degenerative process with failure to repair into an acute inflammatory process with self-regeneration. The aim of this study was to describe 5 cases of epicondylitis that failed to respond to routine therapeutic measures, in which we used ultrasound-guided percutaneous tenotomy with favourable results.

[Ultrasound findings in chronic subacromal pain syndrome]. / Hallazgos ecográficos en el síndrome de dolor subacromial crónico.

OBJECTIVE: Subacromial pain syndrome is a clinical picture characterised by pain located around the acromion triggered or exacerbated by shoulder movements. Ultrasound is a suitable imaging technique to evaluate the soft tissues occupying the subacromial space. The aim of this study was to describe the ultrasound findings in patients diagnosed with chronic subacromial pain syndrome by age, sex, and time since onset. MATERIAL AND METHODS: We conducted a retrospective study of patients diagnosed with chronic SDS who underwent shoulder ultrasound. The variables studied were age, sex, affected side, time since onset, sonographic findings and ultrasound diagnosis. A descriptive study of the variables and statistical inference was performed with the chi-square test. RESULTS: A total of 253 clinical histories of patients who underwent shoulder ultrasound were reviewed. Of these, 100 were selected who met the pre-established criteria. Involvement was bilateral in 5 of them and consequently the total number of ultrasound scans reviewed was 105. Differences were found between ultrasound finding by age, but not by sex or time since onset. CONCLUSIONS: The findings of this study indicate that there is good clinical-radiological correlation between subacromial pain syndrome and ultrasound findings. The structure most frequently involved in the origin of the pain was the supraspinatus tendon. Differences were found by age but not by sex or the time since onset.

Hallazgos ecográficos en el síndrome de dolor subacromial crónico / Ultrasound findings in chronic subacromal pain syndrome

OBJETIVO: El síndrome de dolor subacromial es un cuadro clínico caracterizado por dolor localizado alrededor del acromion que se desencadena o se exacerba con los movimientos del hombro. La ecografía es una técnica de imagen adecuada para evaluar los tejidos blandos que ocupan el espacio subacromial. El objetivo de este trabajo es describir los hallazgos ecográficos en pacientes diagnosticados de síndrome de dolor subacromial crónico relacionándolos con el sexo, la edad y el tiempo de evolución. MATERIAL Y MÉTODOS: Estudio retrospectivo de pacientes diagnosticados de SDS crónico a los que se realiza ecografía de hombro. Las variables estudiadas han sido: edad, sexo, lado afecto, tiempo de evolución, hallazgos ecográficos y diagnóstico ecográfico. Se realiza una presentación descriptiva de las mismas y la inferencia estadística mediante el test de la Chi-cuadrado. RESULTADOS: Se revisan 253 historias clínicas de pacientes a los que se realizó una ecografía de hombro y se seleccionan 100 que cumplían los criterios prefijados; en 5 de ellos la afectación era bilateral, por lo que el total de ecografías revisadas es de 105. Se encuentran diferencias entre los hallazgos ecográficos en relación con la edad, no así con el sexo o el tiempo de evolución. CONCLUSIONES: De los datos encontrados se extrae que existe una buena correlación clínico-radiológica entre el síndrome de dolor subacromial y los hallazgos ecográficos, que la estructura más frecuentemente involucrada en el origen del dolor es el tendón del supraespinoso y que no existen diferencias en los hallazgos y diagnósticos ecográficos en función del sexo del paciente ni del tiempo de evolución, pero que sí existen en relación con la edad

OBJECTIVE: Subacromial pain syndrome is a clinical picture characterised by pain located around the acromion triggered or exacerbated by shoulder movements. Ultrasound is a suitable imaging technique to evaluate the soft tissues occupying the subacromial space. The aim of this study was to describe the ultrasound findings in patients diagnosed with chronic subacromial pain syndrome by age, sex, and time since onset. MATERIAL AND METHODS: We conducted a retrospective study of patients diagnosed with chronic SDS who underwent shoulder ultrasound. The variables studied were age, sex, affected side, time since onset, sonographic findings and ultrasound diagnosis. A descriptive study of the variables and statistical inference was performed with the chi-square test. RESULTS: A total of 253 clinical histories of patients who underwent shoulder ultrasound were reviewed. Of these, 100 were selected who met the pre-established criteria. Involvement was bilateral in 5 of them and consequently the total number of ultrasound scans reviewed was 105. Differences were found between ultrasound finding by age, but not by sex or time since onset. CONCLUSIONS: The findings of this study indicate that there is good clinical-radiological correlation between subacromial pain syndrome and ultrasound findings. The structure most frequently involved in the origin of the pain was the supraspinatus tendon. Differences were found by age but not by sex or the time since onset