Musculoskeletal ultrasonographic evaluation of perineural injection therapy versus therapeutic ultrasound in chronic lateral epicondylitis

Egyptian Rheumatology and Rehabilitation

Table 3 Comparison of tenderness grading scale, pain intensity measured by VAS scale, PRTEE score, and US findings before and after treatment in PNI therapy group

Clinical scores	PNI therapy group (pre-treatment) (n = 15)	PNI therapy group (post-treatment) (n = 15)	p value	Significance
Tenderness grading scale [median (range)]	2 (1–3)	1 (0–2)	< 0.001	Very HS^σ
VAS [median (range)]	8 (4–10)	2 (1–5)	< 0.001	Very HS^σ
PRTEE score (mean ± SD)	53.29 ± 15.69	24.4 ± 11.86	< 0.001	Very HS^σ
US findings	US findings pre-treatment (PNI group)	US findings post-treatment (PNI group)	p value	Significance
Hypoechoic area in CET (+ve/−ve) no.	14/1	3/12	< 0.001	Very HS^§
Disturbed fibrillar pattern (+ve/−ve) no.	9/6	3/12	0.025	S^¶
Tendon thickness (cm) (mean ± SD)	0.53 ± 0.04	0.53 ± 0.04	0.131	NS^*
Enthesophyte (+ve/−ve) no.	9/6	8/7	0.713	NS^¶
Osteophyte (+ve/−ve) no.	4/11	4/11	1	NS^§
Calcification (+ve/−ve) no.	4/11	3/12	1	NS^§
Bone surface irregularity/erosion (+ve/−ve) no.	8/7	8/7	1	NS^¶
Tendon tear (+ve/−ve) no.	1/14	1/14	1	NS^§
Power Doppler signal (+ve/−ve) no.	4/11	0/15	0.1	NS^¶

Statistical methods used ^σpaired Student t test, ^¶Chi-square test, ^*Student t test, and ^§Fisher exact test
CET common extensor tendon
The p value was considered non-significant (NS) if p > 0.05, significant (S) if p ≤ 0.05, highly significant (HS) if p ≤ 0.01, and very highly significant (HS) if p < 0.001
All clinical scores were very highly significantly lower than corresponding values before treatment (p value < 0.001). Ultrasonographic evaluation post-PNI treatment showed a very highly significant decrease in the presence of CET hypoechoic areas (p value < 0.001) and a significant decrease in the disturbed fibrillar pattern (p value = 0.025)