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J Korean Acad Rehabil Med. 2009 Feb;33(1):77-83. Korean. Original Article.
Jung KH , Hwang JH , Chang HJ , Yoon YC , Park MJ , Yoo JC , Park WH .
Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea. hwanglee@skku.edu
Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
Department of Sports Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
Abstract

OBJECTIVE: To evaluate the effect of extracorporeal shock wave therapy (ESWT) and the improvement of ultrasonographic findings in refractory chronic epicondylitis of the elbow. METHOD: Twenty seven patients (7 men, 20 women, mean age 47) with minimum 1 year history of chronic epicondylitis of the elbow that was unresponsive to conventional therapy were included. Each patient was treated with 3~4 sessions of low-energy (0.06~0.12 mJ/mm2, 2000 impulses) ESWT. A 100-point scoring system, Nirschl score and Roles and Maudsley score were evaluated before treatment and at the 3- and 6-month follow-up. Ultrasonography was performed before treatment and at the 3-month follow-up. RESULTS: Total score of a 100-point scoring system and Nirschl score were significantly improved at the 3- and 6-month follow-up compared to before treatment (p<0.05). Follow up ultrasonography was performed in twenty one patients. Eighteen of 21 patients (85.7%) showed improvement of tendinosis and 4 of 6 patients (66.7%) showed improvement of tear and 3 of 10 patients (30.0%) showed improvement of calcification on ultrasonography. CONCLUSION: ESWT is safe and effective modality in the treatment of refractory chronic epicondylitis of the elbow. And ultrasonography can be a useful method to evaluate the therapeutic effect of ESWT.

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