(Press-News.org) CHICAGO – Researchers in London say they have found an effective two-part treatment for microtears in the hamstring: injections of the patient's own blood and a steroid along with "dry-needling," in which repeated needle punctures cause controlled internal bleeding in the injured area. Results of the study were presented today at the annual meeting of the Radiological Society of North America (RSNA).
"By injecting the patient's own blood where it is needed at the site of a damaged tendon, we help the patient heal themselves," said lead researcher Waseem A. Bashir, M.D., a radiologist at Royal National Orthopaedic Hospital and Ealing Hospital in London. "Blood contains many growth factors, and the injections have been shown to promote faster healing of certain injuries."
Hamstring tendinopathy is a common sports injury that occurs in soccer, gymnastics, karate or any sport that requires quick acceleration. It may be caused by an improper warm-up or, in an elite athlete, as the result of repetitive strain. Unlike a torn or ruptured tendon that can be surgically repaired, the tiny microtears that characterize chronic tendinopathy are not easily diagnosed, are difficult to heal and often sideline athletes for long periods, if not permanently.
"Patients with hamstring tendinopathy will experience pain walking or climbing stairs and even while sitting or riding in a car," Dr. Bashir said. "The condition is literally a pain in the butt."
In the study, 42 patients with suspected hamstring microtearing underwent ultrasound and MRI to confirm the tendinopathy and then were randomly assigned to one of three treatment groups. The first group received an injection of both a long-lasting anesthetic and steroid on the surface of the tendon, as well as the dry-needling procedure at the site of microtears.
The second group received an injection of the anesthetic along with two to three milliliters of their own blood, called an autologous blood injection (ABI), and dry-needling. The third group received a local anesthetic, a steroid and ABI along with dry-needling.
"The injections were all performed with ultrasound and color Doppler, which allows us to watch in real-time where the needle is going," Dr. Bashir said. "During the dry-needling, we can see blood flow increase in the area."
Following their treatments, all patients in the study participated in a structured six-week physiotherapy program. The patients were then evaluated at various intervals over a one-year period to assess their levels of pain and functioning.
Patients treated solely with an injection of a steroid and dry-needling reported improved functionality for only three to 12 weeks after treatment. A year later, patients in this group reported being at pre-treatment levels of pain and functionality. Patients who received their own blood plus dry-needling reported significant improvements in functionality even one year after the treatment.
Patients who received both their own blood and a steroid along with dry-needling at the site of tendon damage experienced the most significant reduction in pain levels and the most sustained functional improvement one year following treatment.
"Ultrasound-guided ABI in the hamstring, in combination with a local steroid and dry-needling, appears to be a more clinically effective alternative to the current standard, steroid therapy," Dr. Bashir said. "A few of our soccer-playing patients had been told their condition was untreatable and they had basically given up all hope of playing again. They were amazed to be able to play again after our treatment and physical therapy."
He added that ABI therapy has also been an effective treatment for microtears in other tendons, including the elbow, the patellar tendon and those in the rotator cuff within the shoulder.
###
Dr. Bashir's coauthor is David A. Connell, M.D.
Note: Copies of RSNA 2010 news releases and electronic images will be available online at RSNA.org/press10 beginning Monday, Nov. 29.
RSNA is an association of more than 46,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)
Editor's note: The data in these releases may differ from those in the published abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA Newsroom at 1-312-949-3233.
For patient‑friendly information on MRI and ultrasound, visit RadiologyInfo.org.
END
CHICAGO – For years, it was believed that obese women were at lower risk for developing osteoporosis, and that excess body fat actually protected against bone loss. However, a study presented today at the annual meeting of the Radiological Society of North America (RSNA) found that having too much internal abdominal fat may, in fact, have a damaging effect on bone health.
"We know that obesity is a major public health problem," said the study's lead author, Miriam A. Bredella, M.D., a radiologist at Massachusetts General Hospital and assistant professor of radiology at ...
CHICAGO – Using functional magnetic resonance imaging (fMRI), researchers have captured pictures of the brain while patients experienced a pain stimulus with and without acupuncture to determine acupuncture's effect on how the brain processes pain. Results of the study, which the researchers say suggest the effectiveness of acupuncture, were presented today at the annual meeting of the Radiological Society of North America (RSNA).
"Until now, the role of acupuncture in the perception and processing of pain has been controversial," said lead researcher Nina Theysohn, M.D., ...
A new report in the December Cell Metabolism identifies a protein without which diets high in saturated fat lead to a massive inflammatory response that can prove fatal. The studies in mice suggest that deficiencies in this protective pathway could promote inflammation in those who regularly consume high levels of saturated fat.
"In mice without this protein that ate a lot of saturated fat, the lymph nodes blew up to extreme levels," said Sander Kersten of the Nutrigenomics Consortium and Wageningen University in the Netherlands. "I'd never seen anything like it before."
Kersten ...
Our brains are packed with cholesterol, almost all of which has to be produced within the brain itself, where it is critical for normal brain functions. Now, a new study in the December Cell Metabolism, a Cell Press publication, reveals how that critical cholesterol synthesis in the brain is derailed in mice with diabetes.
The findings offer a new explanation for the neurologic and cerebral complications that come with diabetes, including cognitive dysfunction, depression, and an increased risk of Alzheimer's disease, according to the researchers.
"People with diabetes ...
HOUSTON - (Dec. 1, 2010) – SRC-1 (steroid receptor coactivator) orchestrates glucose production in the liver, regulating the activity of a cascade of enzymes that turns sugar production on and off in the liver, said Baylor College of Medicine (www.bcm.edu) and Duke University Medical Center (www.dukehealth.org) researchers in a report that appears in the current issue of Cell Metabolism (http://www.cell.com/cell-metabolism/).
"As we achieve a better understanding of gluconeogenesis (production of glucose) in the liver, we can look for new ways to treat metabolic diseases ...
Washington, D.C. (November 30, 2010) -- Nuclear magnetic resonance (NMR) is one of the best tools for gaining insight into the structure and dynamics of molecules because nuclei in atoms within molecules will behave differently in a variety of chemical environments. Nuclei can be thought of as tiny compasses that align when placed in the field of a strong magnet. Similar to magnetic resonance imaging (MRI), conventional NMR uses short pulses of radio waves to drive nuclei away from equilibrium and a 'signal' emerges as nuclei slowly realign with the field.
Results reported ...
Washington, D.C. (November 30, 2010) -- One of the holy grails of nanotechnology in medicine is to control individual structures and processes inside a cell. Nanoparticles are well suited for this purpose because of their small size; they can also be engineered for specific intracellular tasks. When nanoparticles are excited by radio-frequency (RF) electromagnetic fields, interesting effects may occur. For example, the cell nucleus could get damaged inducing cell death; DNA might melt; or protein aggregates might get dispersed.
Some of these effects may be due to the ...
Washington, D.C. (November 30, 2010) -- Quantum information processing is arguably one of the most fascinating facets of modern quantum physics.
A quantum computer operates with quantum bits (qubits) as units of information. Obeying the laws of quantum mechanics, such a computer would be capable of addressing several of the most difficult computational tasks unsolvable with present technology. In the past few decades, scientists learned to perform room-sized experiments to optically control and read out a small number of qubits.
Now, researchers in Germany have successfully ...
Washington, D.C. (November 30, 2010) -- A broad review of current research on nuclear power economics has been published in the Journal of Renewable and Sustainable Energy. The report concludes that nuclear power will continue to be a viable power source but that the current fuel cycle is not sustainable. Due to uncertainty about waste management, any projection of future costs must be built on basic assumptions that are not grounded in real data.
"The goal of this study was to determine what assumptions are key to reaching conclusions about the relative costs of technologies," ...
SEATTLE – The worst global economic crisis in decades has not stopped public and private donors from giving record amounts of money to health assistance for developing countries, according to a new report by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
The research shows that development assistance for health has grown 375% from $5.66 billion in 1990 to $26.87 billion in 2010. However, IHME's preliminary estimates show that the growth rate is slowing. Between 2004 and 2008, the period of the most dramatic increases in health funding, ...
