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

Egyptian Rheumatology and Rehabilitation

Table 4 Comparison of tenderness grading scale, pain intensity measured by VAS scale, PRTEE score, and US findings before and after treatment in TUS therapy group

Clinical scores	TUS therapy group (pre-treatment) (n = 15)	TUS therapy group (post-treatment) (n = 15)	p value	Significance
Tenderness grading scale [median (range)]	2 (2–3)	2 (1–3)	< 0.001	Very HS^σ
VAS [median (range)]	8 (5–10)	2 (1–7)	< 0.001	Very HS^σ
PRTEE score (mean ± SD)	48.13 ± 9.58	33.27 ± 8.40	< 0.001	Very HS^σ
US findings	US findings pre-treatment (TUS group)	US findings post-treatment (TUS group)	p value	Significance
Hypoechoic area in CET (+ve/−ve) no.	3/12	7/8	0.020	S^§
Disturbed fibrillar pattern (+ve/−ve) no.	11/4	7/8	0.136	NS^§
Tendon thickness (cm) (mean ± SD)	0.55 ± 0.07	0.53 ± 0.07	0.026	S^*
Enthesophyte (+ve/−ve) no.	8/7	7/8	0.715	NS^§
Osteophyte (+ve/−ve) no.	3/12	3/12	1	NS^§
Calcification (+ve/−ve) no.	3/12	2/13	1	NS^§
Bone surface irregularity/erosion (+ve/−ve) no.	10/5	9/6	0.705	NS^¶
Tendon tear (+ve/−ve) no.	1/14	1/14	1	NS^§
Power Doppler signal (+ve/−ve) no.	4/11	1/14	0.330	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 the corresponding values before treatment (p value < 0.001). Ultrasonographic findings post-intervention showed a significantly decrease of CET hypoechoic areas (p value = 0.02) the tendon thickness as compared to pre-treatment values (p value = 0.026)