Comparison of ultrasound- vs. landmark-guided injections for musculoskeletal pain: an umbrella review.
Peng-Chieh Shen, Ting-Yu Lin, Wei-Ting Wu and 2 others
PMID 39185547WHAT IT FOUND
Ultrasound guidance is consistently more accurate than landmark techniques for joint injections.
However, this precision rarely translates to better pain relief or function for the shoulder, with most studies showing no significant clinical difference between the two methods.
Key findings
01Ultrasound guidance demonstrated superior accuracy for hip and knee injections compared to landmark techniques.
02For shoulder injections, ultrasound guidance did not consistently provide better pain relief or functional improvement compared to landmark guidance.
03Ultrasound guidance was significantly more effective than landmark guidance for reducing pain and improving function in bicipital groove and de Quervain disease injections.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The quality of the included reviews was mixed; only 3 were rated high quality, while 13 were low or critically low. There was considerable heterogeneity in the original studies, including differences in corticosteroid type, volume, and injector experience. The review could not fully evaluate the impact of concurrent physiotherapy or medication because this data was often missing. Many studies used different outcome measures, making it difficult to pool results accurately.
Declared interests
The authors declared no conflicts of interest. Funding was provided by National Taiwan University Hospital, the Ministry of Science and Technology, and the Taiwan Society of Ultrasound in Medicine.
The easy way to misread this
Do not assume that higher injection accuracy automatically leads to better patient outcomes. While ultrasound is more precise, the evidence for shoulder pain and function improvement remains inconclusive and often shows no significant difference compared to landmark techniques.