High Volume Image-Guided Injection (HVIGI) for Achilles Tendinopathy

High Volume Image-Guided Injection (HVIGI) for Achilles Tendinopathy

Achilles Tendinopathy is a pathological condition that occurs when the Achilles tendon, which connects the calf muscles to the heel bone, becomes inflamed. It is characterized by pain, swelling, and limited function of the Achilles tendon, often affecting individuals who take part in athletic activities such as running. Achilles tendinopathy can have significant impact on the patient's daily life, leading to reduced mobility.

What are the causes of Achilles tendinopathy?

The Achilles tendon, the largest and strongest tendon in the human body, is crucial for walking, running, and jumping, making it vulnerable to injuries. Some common causes of tendonopathy include:

  • Repetitive activities: Activities involving repetitive movements of the foot and ankle, such as running, jumping, or dancing, can put pressure on the Achilles tendon, leading to its inflammation.
  • Sudden increase in activity: A drastic increase in the intensity, duration, or frequency of exercise without proper training can overload the Achilles tendon and cause injury.
  • Improper footwear: Shoes that do not provide adequate support or cushioning against shocks can contribute to the development of tendonopathy by increasing the pressure on the tendon during movement.

What are the symptoms of Achilles tendinopathy?

The symptoms of Achilles tendinopathy can vary in severity but generally include:

  • Pain: Pain in the tendon area, especially in the morning or after a period of rest, is a common symptom.
  • Swelling: Swelling along the Achilles tendon, especially near the heel, may occur due to inflammation.
  • Difficulty in movement: Pain and discomfort may worsen with activity, making walking, running, or climbing stairs difficult.
  • Reduced range of motion: Decreased flexibility and range of motion in the ankle may occur as a result of Achilles tendonopathy.

What is the role of ultrasound in cases of Achilles Tendinopathy?

Ultrasound is the preferred imaging method for tendons, and the role of New Ultrasound Techniques is particularly critical for the diagnosis and management of Achilles tendinopathy.

Research has shown that in cases of Achilles tendinopathy, there is increased microvascularization in the area, as well as neovascularization, meaning the formation of new blood vessels, which is associated with pain, reduced function, and the chronic nature of the condition.

Newer Ultrasound Techniques allow for the visualization of blood flow in small vessels and the detection of possible neovascularization, enabling a specialized Radiologist to diagnose and evaluate the condition with absolute accuracy, as well as to perform Ultrasound-guided Injection Therapy, where appropriate.

Treatment of Achilles Tendinopathy: High-Volume Image-Guided Injection (HVIGI)

High-Volume Image-Guided Injection (HVIGI) is a modern therapeutic technique for cases of Achilles tendonitis that aims to disrupt the neovascularization affecting the tendon.

HVIGI therapy involves ultrasound-guided injection of a mixture of local anaesthetic and saline between the tendon and the paratendon or between the tendon and Kager’s fat pad, eliminating neovascularization, alleviating pain, and improving tendon function.

Ultrasound-guided HVGI is a safe, minimally invasive treatment for patients with Achilles tendinopathy, which can be an alternative to surgical intervention. The role of Ultrasound Guidance during HVGI treatment is critical for the safety of the procedure as well as for the precise placement of the injection in the anatomical area affected.

Conclusion

Due to the importance of the Achilles tendon in body mobility, Achilles tendinopathy can significantly impact the patient's daily life. High-Volume Image-Guided Injection (HVIGI) represents an innovative option for the treatment of Achilles tendinopathy, as it relieves inflammation by eliminating neovascularization around the tendon, without the use of cortisone or other drugs. Minimally invasive, ultrasound-guided therapies continue to evolve, offering improved therapeutic outcomes, reduced recovery time, and the potential to avoid surgical intervention.

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  • An excellent scientist with advanced knowledge, capable of diagnosing damage caused by rheumatic diseases and thus contributing to their effective treatment. I hope there are more scientists like her so that patients can continue to enjoy a good quality of life, as these diseases are incurable.

    Alexia S.

  • I visited Ms. Plagou for a health problem I had with my right Achilles tendon. I congratulate her for her scientific expertise and her unique approach with patients. I thank her very much, and she deserves many congratulations, as do her polite associates.

    Nestoras N.

  • As a surgeon I must simply say, UNBELIEVABLE!! Within 15 minutes I was completely rid of the intense discomfort in my shoulder that had been bothering me for several years. My shoulder feels as it was 10 years ago. Zero pain, incredibly free movement. Congratulations, Mrs. Plagou.

    Dr. Dimitrios Alexopoulos

  • I would like to express my gratitude to Dr. Athena Plagou. With the Barbotage method she applied, she relieved me from terrible pains I had been suffering from for several months due to calcifications in my shoulder.

    Before I learned about Dr. Plagou, I had tried cortisone injections, hyaluronic acid injections, and anti-inflammatory medications. Unfortunately, nothing yielded results.

    I underwent the Βarbotage procedure in her clinic, very easily and painlessly. When it was over, I had stopped feeling any pain, and it has been three years since then without the slightest discomfort.

    Thank you from the bottom of my heart.

    Mary P.

  • State-of-the-art clinic and equipment, exceptional doctor with extensive experience and impressive specialization.

    Eirini D.

  • Ms. Plagou is an excellent scientist with accurate diagnoses, distinguished in her field, and an exceptional person at the same time. She deserves congratulations!

    Dr. Chrysovalantou Souhlaki

  • I had been suffering from Calcific Tendonitis in my left shoulder for over three months, resulting in severe pain. Before I learned about Ms. Plagou, I had tried anti-inflammatory medications, cortisone injections, physiotherapy, all without success, and I was on the verge of serious surgery with doubtful outcomes.

    I underwent Barbotage in her clinic very easily, quickly, and painlessly. As soon as the brief procedure was over, my pain ceased, I slept well, and I quickly resumed all my activities.

    I want to thank Ms. Plagou both for the impeccable handling of my problem stemming from her excellent scientific training, as well as for her kindness and friendly demeanor.

    Zoe K.

  • I am very grateful to Dr. Athena Plagou. With her high specialization and professionalism, she accurately diagnosed and successfully treated the tendonitis I suffered from in both of my shoulders.

    Other specialists I had consulted previously had suggested arthroscopy, which I did not want to undergo due to my age (86) and because the treatment was not guaranteed.

    With the special method used by Dr. Plagou, the fluid causing the pain was absorbed, and the pain was immediately relieved without recurrence for the past four months. Besides her high specialization and effectiveness, Dr. Plagou is also very friendly and fully explains to patients the cause of the problem and the treatment process. Her assistant is also very friendly and efficient. Sincere thanks again.

    Nikos K.

  • Her experience, her thoroughness and her love for what she does make her one of a kind. My daughter suffered for months with pain in her wrist. Having visited several orthopedists, having done magnetic resonance imaging and x-rays, only Mrs. Plagou found that she had fluid in her wrist and referred us to a pediatric rheumatologist.

    I recommend her. Her assistant is also extremely helpful and kind.

    Katerina A.

  • I want to publicly thank my colleague Athena Plagou for her immediate and effective intervention to treat the problem in my shoulder. The Barbotage method she applied, and in which she is specialized, quickly relieved me from the painful symptoms of Calcific Tendonitis. The return to my daily routine was immediate.

    Dr. Vicky Bizimi

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