Purpose of Review Tendinopathy describes a combination of pain, swelling, and impaired performance of the tendon and around structures. There are various treatment options for tendinopathy with unclear efficacy. Dry needling involves inserting needles into the affected tendon, and it is thought to disrupt the chronic degenerative process and encourage localized bleeding and fibroblastic proliferation. The purpose of this review is to review the use of dry needling as a treatment modality for tendinopathy. Recent Findings The effectiveness of dry needling for treatment of tendinopathy has been evaluated in 3 systematic reviews, 7 randomized controlled trials, and 6 cohort studies. The following sites were studied: wrist common extensor origin, patellar tendon, rotator cuff, and tendons around the greater trochanter. There is considerable heterogeneity of the needling techniques, and the studies were inconsistent about the therapy used after the procedure. Most systematic reviews and randomized controlled trials support the effectiveness of tendon needling. There was a statistically significant improvement in the patient-reported symptoms in most studies. Some studies reported an objective improvement assessed by ultrasound. Two studies reported complications. Summary Current research provides initial support for the efficacy of dry needling for tendinopathy treatment. It seems that tendon needling is minimally invasive, safe, and inexpensive, carries a low risk, and represents a promising area of future research. In further high-quality studies, tendon dry needling should be used as an active intervention and compared with appropriate sham interventions. Studies that compare the different protocols of tendon dry needling are also needed.

The study aimed to develop a grading scale for evaluating degenerative changes in uncovertebral joints (UVJs) found on computed tomography (CT) scans, and assess the intra-and inter-rater reliability of this scale. The study included 50 subjects (average age 55.12 ± 13.76 years) referred for CT examinations due to cervical complaints. Three researchers developed a reading protocol using a semiquantitative grading scale of UVJ degenerative changes. CTs were read and reread several times to refine the protocol. Subsequently, the reader read and reread 20 CTs (C3-C7 bilateral, altogether 200 UVJs) 2 weeks apart in order to assess the intra-rater reliability.The second reader, after the training, read the same 20 CTs (yet, C4-C6 bilateral, altogether 120 UVJs) in order to assess the inter-rater reliability. The additional 30 CTs were evaluated to analyze the prevalence and associations between the studied parameters. The final grading scale included joint space narrowing, osteophyte, subchondral sclerosis, subchondral cyst, hypertrophy, cortical erosion, and vacuum phenomenon. The intra-rater agreement ranged from very good in joint space narrowing (k = 0.757), osteophyte grade (k = 0.748), subchondral cyst (k = 0.716), hypertrophy (k = 0.728), vacuum phenomenon (k = 0.712) to good (k = 0.544) in subchondral sclerosis, and fair in cortical erosion (k = 0.36). For the overall UVJ degeneration grade, the intra-rater agreement was very good (k = 0.616) and the inter-rater reliability was good (k = 0.468). 77.6% of the evaluated UVJs exhibited some degenerative changes. Our grading scale is the first to evaluate UVJs presenting good-very good intra-rater and inter-rater reliability which can be utilized in further clinical studies and assess degenerative changes in UVJs.

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