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Abstrakt

Steroid injections are widespread in the rehabilitation of Achilles tendon injuries and placement has previously been palpation guided. This literature review applies the Heath Technology Assessment (HTA) approach in order to assess the differences in efficacy between ultrasound guided and palpation guided placement of peritendinous steroid injections in patients with Achilles tendinopathy. The HTA is based on literature found trough structured information retrieval. The efficacy of steroid injections is dependent on the precision of the injection, which can be increased by using ultrasonography as an aid. Ultrasonography is inexpensive and, so far, there is no evidence of side effects. In two independent studies, not directly comparable, in patients with Achilles tendinopathy the conventional palpation-guided SI in one study had an effect of 32% compared to effect of 79% in the ultrasonographyguided SI in the other study. This HTA indicates that using ultrasonography as a guidance device while injecting steroids in patients with Achilles tendinopathy increases the efficacy and decreases the side effects. However, further comparative randomized controlled trials are required to properly assess the efficacy.

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