Technical Innovation Case Report: Ultrasound-Guided Prolotherapy Injection for Insertional Achilles Calcific Tendinosis

Technical Innovation Case Report: Ultrasound-Guided Prolotherapy Injection for Insertional Achilles Calcific Tendinosis

Abstract

We describe the use of ultrasound guidance for hyperosmolar dextrose (prolotherapy) injection of the distal calcaneal tendon specifically just anterior to identified enthesophytes in patients with insertional Achilles calcific tendinosis refractory to conservative treatment. This specific technique has not to our knowledge been described or used in literature previously.

Introduction: Insertional Achilles tendinosis is a common chronic overuse injury in both athletes and nonathletes alike. Symptoms can last anywhere from weeks to years and cause significant difficulties in daily activities. Treatments can range widely from rest, NSAIDs, topical medications, physical therapy, various injections, and in extreme cases surgical intervention.

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