I had an ultrasound study done on my left elbow because of chronic tennis elbow. I watched the screen while the test was being done, but I couldn't really tell what was going on. What kinds of things can the radiologist see with this problem that might help me?
Ultrasound studies of tennis elbow have been able to show that ultrasound is an excellent test tool to see what's going on inside that painful elbow. It shows structural changes like tendon thickening, tendon tears, and blood flow (increased or decreased). Increased blood flow suggests an active healing process is going on. Decreased blood flow signals a pathologic condition.
Ultrasound also provides the physician with some idea of how much collagen fiber degeneration is present and whether or not there is any inflammation going on. They look for the presence immune inflammatory cells like neutrophils and macrophages as indicators of an active inflammatory process.
So many studies showed that chronic tennis elbow doesn't have any inflammation that the condition was renamed from tendinitis to tendinosis. There aren't any immune blood cells present but plenty of scar tissue called fibrosis and necrotic (dead) cells.
Ultrasound studies performed early on in the condition can help guide treatment. Instead of focusing on pain with steroid injections, for example, physicians can recommend treatments that improve the blood supply to the area and foster tendon healing.
Andrew W. Clarke, MD, et al. Lateral Elbow Tendinopathy. Correlation of Ultrasound Findings with Pain and Functional Disability. In The American Journal of Sports Medicine. June 2010. Vol. 38. No. 6. Pp. 1209-1214.
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