This 2016 study explores ultrasound-guided interventions for chronic tendinopathy, targeting degenerative angiofibroblastic hyperplasia rather than simple inflammation. The authors detail four primary percutaneous procedures: Percutaneous Needle Tenotomy (PNT) to stimulate healing through mechanical disruption; Percutaneous Ultrasonic Tenotomy (PUT) using the Tenex system to emulsify and remove damaged tissue; High-Volume Injection (HVI) to strip away painful neovessels and nerves; and Percutaneous Needle Scraping (PNS) to disrupt the tendon-fat pad interface. Ultimately, the study concludes that these minimally invasive techniques are safe and show significant promise for treating recalcitrant tendon pain by addressing its specific underlying pathology.