الفهرس 
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Abstract
Tendinopathy is the most common tendon disorder and it is characterized by activity –related pain, focal tendon tenderness, and decreased strength and movement of affected area58.
Ultrasound is a non invasive, non ionizing imaging technique with real time imaging capability that gained a widespread acceptance as guidance in musculoskeletal interventions, which allow continuous monitoring of the needle position29.
The aim of the current study is to evaluate the effectiveness of the percutaneous ultrasound guided intervention in improving or treating different tendinopathy problems.
Our study included 30 patients who have been classified into two groups: group I: involved 24 patients, who had been diagnosed with non calcific tendinopathy, and treated by ultrasound guided corticosteroid injection. And group II: involved 5 patients, who had been diagnosed with calcific tendinosis, and treated by Barbotage.
Regarding group I patients (non calcific tendinosis), the technical success rate was 100% and clinical success rate was 87%, among them 62% of patients showed complete clinical improvement and 25% of them, showed marked reduction of their pain and disability score. The mean pain score was 3 pre-treatment and reduced to 0.5 at the 6th month post-treatment. The mean disability score was 1.5 pre-treatment and reduced to 0 at the 6th month post-treatment. 58% of the patient showed total disappearance of tendinosis sonographically, 17 % of them showed partial regaining of the normal tendon sonographically at the 6th month post-treatment. 88% of the patients showed no complication either during the injection or on follow up visits.
Regarding group II patients (calcific tendinosis), the technical success rate was 60 % and clinical success rate was 80%, among them 60% of patients showed complete clinical improvement and 20% of them, showed marked reduction of their pain and disability score. The mean pain score was 3.5 pre-treatment and reduced to 1 at the 6th month post-treatment. The mean disability score was 2.5 pre-treatment and reduced to 1 at the 6th month post-treatment. 60% of the patient showed total disappearance of calcification sonographically and radiography, 20 % of them showed scattered calcification less than 3mm in size at the 6th month post-treatment. 100 % of the patients showed no complication either during the barbotage or on follow up visits.
In conclusion:
Corticosteroid injection is a relatively safe and effective therapy in cases of tendinosis for short and intermediate term of treatment. It is more effective and safer by ultrasound guidness rather than blind method that depend on doctor expertise.
Ultrasound guided aspiration and lavage (Barbotage) is a highly effective, less aggressive method of treatment in cases of calcific tendinosis, especially for cases with severe pain that not respond to other conservative methods.