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Table 4 – Qualitative synthesis of results and overview of evidence

From: Non-pharmacological interventions and corticosteroid injections for the management of the Achilles tendon in inflammatory arthritis: a systematic review

 

DOMAIN

Pain

Ultrasound Identified Abnormalities and Vascularity

B Mode Ultrasound

Doppler Ultrasound

Visual Analogue Scale

(units not specified)

Entheseal Thickness

(mm)

Bursitis

(n)

Bone Erosion

(n)

Enthesophyte

(n)

Entheseal Hypoecho-genicity

(n)

Peri-tendinous Oedema

(n)

Entheseal Vascularity

(Grade)

Bursal Vascularity

(Grade)

Huang et al. [26]

Baseline:

5.3 ± 0.7

Week 2:

0.8 ± 1.0

Week 4:

0.5 ± 0.6

Week 8:

1.1 ± 1.1

Week 12:

1.5 ± 0.8

p < 0.05

(mean ± SD)

Baseline:

7.6 ± 3.1

Week 2:

6.3 ± 2.4

Week 4:

6.2 ± 2.1

Week 8:

6.2 ± 1.9

Week 12:

6.2 ± 1.9

p > 0.05

(mean ± SD)

Baseline:

7 detected

Week 2:

4 detected

Week 4:

3 detected

Week 8:

3 detected

Week 12:

3 detected

p > 0.05

Baseline:

4 detected

Week 2:

4 detected

Week 4:

4 detected

Week 8:

4 detected

Week 12:

4 detected

p > 0.05

Baseline:

1 detected

Week 2:

1 detected

Week 4:

1 detected

Week 8:

1 detected

Week 12:

1 detected

p > 0.05

N/A

N/A

Baseline:

Grade 1: 0

Grade 2: 2

Grade 3: 3

Grade 4: 2

Week 2:

Grade 1: 2

Grade 2: 4

Grade 3: 1

Grade 4: 0

Week 4:

Grade 1: 4

Grade 2: 3

Grade 3: 0

Grade 4: 0

Week 8:

Grade 1: 3

Grade 2: 3

Grade 3: 1

Grade 4: 0

Week 12:

Grade 1: 2

Grade 2: 4

Grade 3: 2

Grade 4: 0

N/A

Srivastava & Aggarwal [27]

Baseline:

7 (4–10)

Week 6:

3 (0–7)

p < 0.0001

(mean [range])

Baseline:

6.9 (5.6–9.8)

Week 6:

6.1 (4–9.8)

p < 0.0001

(mean [range])

Baseline:

26 detected

Week 6:

15 detected

p < 0.001

Baseline:

24 detected

Week 6:

24 detected

p > 0.05

Baseline:

3 detected

Week 6:

3 detected

p > 0.05

Baseline:

27 detected

Week 6:

19 detected

p = 0.02

Baseline:

17 detected

Week 6:

5 detected

p > 0.05

Baseline:

2 (0–3)

Week 6:

0 (0–3)

p < 0.0001

(mean [grade range])

Baseline:

2 (0–3)

Week 6:

0 (0–3)

p < 0.0001

(mean [grade range])

Level of Evidence

Weak evidence for corticosteroid injections reducing pain as 2 studies report consistent findings

Weak evidence for corticosteroid injections decreasing entheseal thickness as 2 studies report consistent findings

Weak evidence for corticosteroid injections decreasing the presence of bursitis as 2 studies report consistent findings

Weak evidence for corticosteroid injections not improving the number of bone erosions as 2 studies report consistent findings

Weak evidence for corticosteroid injections not improving the number of enthesophytes as 2 studies report consistent findings

Inconclusive due to lack of studies

Inconclusive due to lack of studies

Weak evidence for corticosteroid injections reducing entheseal vascularity in Achilles enthesis as 2 studies report consistent findings

Inconclusive due to lack of studies