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Published 2 February 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.08.2008.0714]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Novel treatment (new drug/intervention; established drug/procedure in new situation)

Neovascularisation in flexor carpi ulnaris tendinopathy: novel combined sclerosing therapy and eccentric training of the forearms in athletics’ wrist pain

Karsten Knobloch, Andreas Gohritz, Marcus Spies, Peter M Vogt

Hannover Medical School, Plastic, Hand and Reconstructive Surgery, Carl-Neuberg-Str. 1, Plastic, Hand and Reconstructive Surgery, Hannover, 30625, Germany

Correspondence to:
kknobi{at}yahoo.com

SUMMARY

Tendinopathy of the flexor carpi ulnaris tendon is a rare entity. We present a 35-year old tennis player suffering tremendous pain (visual analogue scale (VAS) rating of 9/10) at the flexor carpi ulnaris tendon with adjacent calcification in close proximity to the pisiform bone. Sclerosing therapy using polidocanol under power and laser Doppler guidance was initiated, with immediate decrease of capillary blood flow by 25% with resolution of the neovascularisation in power Doppler. Immediately following sclerosing, the patient’s reported pain level on the VAS was reduced from 9/10 to 4/10. Following a short period of rest, eccentric training of the forearm muscle was initiated over 12 weeks with functional complete recovery and complete resolution of wrist pain.


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