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Image-guided intervention in the management of chronic patellar tendinopathy with calcification: a three-pronged approach
  1. Aqeel Butt1,
  2. Neelan Umaskanth1 and
  3. Ajay Sahu2
  1. 1Medicine, London North West University Healthcare NHS Trust, London, UK
  2. 2Radiology, London North West University Healthcare NHS Trust, London, UK
  1. Correspondence to Dr Aqeel Butt; aqeel.butt{at}


Patellar tendinopathy is a common cause of knee pain and functional impairment in athletes. It is commonly managed using conservative measures such as physiotherapy, but cases that are refractory to such treatment may require a more invasive approach. Various forms of image-guided injection therapy have been described in the literature. We present a case of successful treatment of chronic patellar tendinopathy with calcification with the first reported use of a three-pronged image-guided approach, consisting of dry needling, high volume image-guided injection (but at a reduced dose) and barbotage applied in a single sitting. The patient reported resolution of symptoms persisting to 1 year postprocedure. We suggest that this management option, if supported by further positive research findings, could be used in the future in the management of certain cases of patellar tendinopathy with calcification where conservative measures have failed.

  • radiology
  • interventional radiology
  • tendonopathies
  • ultrasonography
  • jumper's knee

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  • Contributors AB was involved in background research and writing of the various sections of the case report as well as discussions with the patient. AB was not involved in the clinical care of the patient. NU was involved in conducting background research and writing the case report and in discussions with the patient. NU was not involved in the clinical care of the patient. AS performed the initial procedure and was involved in initial discussions with the patient and in background research as well as writing various sections of the report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.