Dr Iain Duncan
lateral epicondylitis

Lateral Epicondylitis: A Therapy Update

Background  Definition: Lateral epicondylitis is a common, painful condition characterized by pain at the lateral side of the elbow, that increases during gripping or squeezing. Though sometimes referred to as “tennis elbow” it occurs mostly in middle aged adults regardless of sporting activity.  Light microscopy reveals both an excess of fibroblasts and blood vessels that […]

PRP (platelet rich plasma) injections for osteoarthritis

Iain Duncan February 2016 I understand the rationale and use of platelet rich plasma (PRP) for tendon problems but I am continually asked about PRP injections for osteoarthritis.  It is less intuitive than its use for tendon pathologies, where the PRP can be seen to simulate a normal healing response. PRP is not “normal” in joints […]

Back pain and Bone scans (updated 2017)

Bone scans of the spine have become a clinically useful part of the evaluation of back pain. Uptake seen on a SPECT-CT correlates with metabolic activity in bone and the increased resolution and specificity of SPECT-CT has allowed a greater number and variety of clinically relevant findings. Most patients with back pain will have an […]

PRP therapy for tendinopathies and tendon tears

Iain Duncan October 2015 PRP (platelet-rich plasma) therapies have been used for over a decade for a whole number of clinical problems (see PRP wikipedia entry). PRP is blood plasma that has been enriched with platelets and contains (and releases through degranulation) several different growth factors and other cytokines that stimulate healing of bone and soft tissue. […]

Ultrasound Elastography

Basic principles Recent advances in ultrasound technology have led over several years to the development of elastography. This is the ultrasound equivalent of clinical palpation. There are different types of shear elastic properties which can be assessed by ultrasound. Several types have developed using different deformation forces and different ways of measuring the force. A […]