Application Of Color Doppler Ultrasonography In The Treatment Of Humeral Epicondylitis With

Part Ⅰ:Literature ResearchThis paper studies the literature on lateral humeral epicondylitis during the past 10 years, we try to review the pathogenesis, treatment and other aspects of this disease.Part Ⅱ:Clinical ResearchObjective:Exploring using value of conventional scan sequence and functional imaging of CDFI in patients with LE. Massage is a very effective way of treating LE, and its focus is to locate and treat the causes tenderness point analysis. The imaging characteristics of ultrasound is that it becomes soft tissue injury disease diagnostic method of choice. This study attempts to take advantage of the high-frequency color Doppler ultrasound, provide a more accurate way to locate a traditional massage to improve clinical results, and provide objective evidence for the efficacy of imaging.Patients and Methods:70 cases of patients with with clinical diagnosed lateral epicondylitis after randomly divided into two groups, received examination of B-mode and CDFI. Treatment groups:After using the Ultrasound guided lesions in the experimental group, with massage to treat lateral epicondylitis. Control Group:After using the traditional method of locating the lesion, with massage to treat lateral epicondylitis. The data of two groups were observed in VAS score, clinical efficacy, treatment times and the change of sonographic (including:common extensor tendon thickness, blood flow, the common extensor tendon tear), and analyzed statistically before and after treatment. Differences were considered to be significant at P<0.05. Peason’ s rank correlation analysis was performed to compare VAS of pain with the injury of the common extensor tendon、the thickness of thecommon extensor tendon and the blood flow, were considered significant at P<0.05.Results1. VAS scores:There were no significant difference between the two groups (P> 0.05) before and after treatment; but there were significantly different (P<0.01) after 7 days and 14days of treatment. There were significantly different (P<0.01) in the two groups before and after treatment comparison.2. Clinical efficacy:By using Ridit analysis, the effective rates of the experimental group are significantly better than the control group (Rexperimental group=0.435, Rcontrol group=0.568, P<0.05).3. There are significant differences between the two groups in the number of treatment (P<0.01), the experimental group (5.97±2.34 times) was significantly less than the control group A (7.67±1.36 times).4. The thickness of the common extensor tendon:Compare before and after treatment in the two groups, there were significant differences (P<0.01); contrast between the two groups before and after treatment, no significant difference (P>0.05).5. The tear of the common extensor tendon:Comparing before and after treatment in the two groups, there were significant differences (P<0.01); contrast between the two groups, there were no significant difference (P>0.05) before treatment, there are significant differences (P<0.05) after treatment.6. CDFI scores:Comparison between two groups before and after treatment, no significant difference (P=>0.05). Comparison within groups before and after treatment were significantly different (P<0.01).7. No correlation were seen between VAS of pain and The thickness of the common extensor tendon (P>0.05); There were positive correlation between VAS of pain and the scores of blood flow (P<0.01, R=0.449).person’ s correlation analysis showed positive correlation between the injury of the common extensor tendon and VAS of pain (P<0.05, R=0.454).Conclusion:1. In this sutudy, we found that the message by sonographical guided is superior than the Traditional method. To improve patient pain, the method by sonographical guided is significantly more quickly and efficiently than traditional method. In the treatment of lateral humeral epicondylitis, the numbers of treatment may decrease by sonographical guided manipulation compared with the traditional methods.2. There were no significant differences between the thickness of the common extensor tendon and VAS scores, but there were positive correlation between VAS of pain and the scores of blood flow and the tear of the common extensor tendon.3. In the study, we found that massage can be used in an incomplete tear of the common extensor tendon. In the treatment of lateral humeral epicondylitis, it is useful to help the common extensor tendon healing, and to improve the situation of acute inflammation lesions by manipulation。4. The tendon thickness cannot be used to estimate the clinical result, but the scores of CDFI and the tear of the tendon can be used to estimate the clinical result.