Comparison of Ultrasound‐Guided to Fluoroscopy‐Guided Biceps Tendon Sheath Therapeutic Injection

Petscavage-Thomas, Jonelle; Gustas, Cristy

doi:10.7863/ultra.15.08076

Cited by 22 publications

(15 citation statements)

References 9 publications

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“…Petscavage-Thomas and Gustas conducted a retrospective study to compare the effectiveness of US- vs fluoroscopy-guided biceps tendon injection at the groove level. 10 In this study, US guidance had a higher success rate with administration of medication inside the tendon sheath. There was no significant difference in pain relief and complication rates.…”

Section: Long Head Of the Biceps Tendonmentioning

confidence: 59%

Ultrasound-guided interventions for painful shoulder: from anatomy to evidence

Chang¹,

Mezian²,

Naňka³

et al. 2018

JPR

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Shoulder pain is a common musculoskeletal disorder of variable etiology, ranging from rotator cuff pathology to peripheral nerve entrapment. Advances in ultrasound (US) technology have allowed static and dynamic evaluation of shoulder problems and most importantly, offer real-time, radiation-free guidance for interventions. The present review aims to describe shoulder anatomy in detail using information from cadaveric models and to illustrate US-guided techniques using clearly labeled figures and videos. The review will also present evidence of specific US-guided therapies for shoulder pain by summarizing landmark studies, systematic reviews, and meta-analyses. The following shoulder structures will be covered: 1) the biceps long head tendon, 2) the acromioclavicular joint, 3) the subacromial–subdeltoid bursa, 4) the glenohumeral joint, 5) the suprascapular nerve, and 6) the axillary nerve.

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Section: Long Head Of the Biceps Tendonmentioning

confidence: 59%

Ultrasound-guided interventions for painful shoulder: from anatomy to evidence

Chang¹,

Mezian²,

Naňka³

et al. 2018

JPR

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“…22 61 65-78 RoB assessment of the retrieved studies is detailed in online supplemental table 3. Imaging Imaging Imaging US versus fluoroscopy [12][13][14][15][16] and 1 study each comparing fluoroscopy with palpation guidance, 53 fluoroscopy with US and palpation guidance, 59 or fluoroscopy with CT-guided interventions, 54 as well as one study comparing either US or fluoroscopy with palpation guidance. 17 The following large joints and periarticular structures were studied: knee (n=10), shoulder (n=9), sacroiliac joint (SIJ) (n=3) and one study each for elbow, wrist, spine, piriformis muscle, hip, trochanteric bursa and ankle.…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies reported better accuracy for needle placement/injectate location (n=8) or synovial fluid acquisition (n=1) using US as compared with palpation-guided injections (seven with moderate RoB 23-26 29 31 56 and two with high RoB), 33 58 while two studies concluded that there was no difference between the two methods (one moderate, one high RoB). 20 32 Results for correct needle placement were heterogenous for comparisons of US with fluoroscopy: one study favoured US for biceps tendon sheath injections (high RoB), 14 one reported better accuracy for SIJ injections using fluoroscopy (high RoB) 15 and another study reported no difference between the techniques for SIJ injections (moderate RoB). 13 Fluoroscopy was superior to palpation-guided injections for injectate location in patients with painful SIJ (low RoB) 53 and superior to CT when assessing the positive rate of discovertebral biopsy cultures at the lumbar spine in patients with osteomyelitis (high RoB).…”

Section: Accuracymentioning

confidence: 99%

“…Long-term pain (ranging from 1 week to 6 months) was found to be lower in US, compared with palpation-guided interventions according to ten studies (five high, five moderate RoB), 19 21 25 27 28 30 33 56-58 whereas four (two high, two moderate RoB) 20 22 32 55 studies found no difference between the groups. Furthermore, five studies comparing US and fluoroscopy (three high, two moderate RoB) [12][13][14][15][16] and one comparing US or fluoroscopy versus palpation-guided injections (moderate RoB) 17 reported no differences in procedural, 13 16 and long-term pain. [12][13][14][15][16][17] One study (low RoB) comparing fluoroscopy with palpation-guided injections reported lower pain levels at 3 months in the fluoroscopy group when adjusting data for baseline pain levels.…”

Section: Safetymentioning

confidence: 99%

“…Furthermore, five studies comparing US and fluoroscopy (three high, two moderate RoB) [12][13][14][15][16] and one comparing US or fluoroscopy versus palpation-guided injections (moderate RoB) 17 reported no differences in procedural, 13 16 and long-term pain. [12][13][14][15][16][17] One study (low RoB) comparing fluoroscopy with palpation-guided injections reported lower pain levels at 3 months in the fluoroscopy group when adjusting data for baseline pain levels. 53…”

Section: Safetymentioning

confidence: 99%

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Value of imaging to guide interventional procedures in rheumatic and musculoskeletal diseases: a systematic literature review informing EULAR points to consider

et al. 2021

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ObjectivesTo summarise current data on the value of imaging to guide interventional procedures in patients with rheumatic and musculoskeletal disease (RMDs) informing an European Alliance of Associations for Rheumatology taskforce.MethodsA systematic literature review was conducted to retrieve prospective and retrospective studies published in English and comparing different (imaging) techniques, different settings and procedural protocols to guide interventions in patients with RMDs. MEDLINE, EMBASE, the Cochrane Library and Epistemonikos databases were searched through October 2021. Risk of bias (RoB) was assessed using the Cochrane RoB tool for randomised trials V.2 (ROB2), the RoB tool for Non-Randomised Studies of Interventions and the appraisal tool for cross-sectional studies.ResultsSixty-six studies were included (most with moderate/high RoB); 49 were randomised controlled trials, three prospective cohort studies and 14 retrospective studies. Fifty-one studies compared either one imaging technique with another imaging technique, or with palpation-guided interventions. Ultrasound (US) was most frequently studied (49/51), followed by fluoroscopy (10/51). Higher accuracy was found for US or fluoroscopy compared with palpation-guided interventions. Studies comparing different imaging techniques (12/51) did not endorse one specific method. Different settings/equipment for imaging-guided procedures (eg, automatic vs manual syringes) were investigated in three studies, reporting heterogeneous results. Fifteen studies compared different imaging-guided procedures (eg, intra-articular vs periarticular injections).ConclusionHigher accuracy of needle positioning at joints and periarticular structures was seen in most studies when using imaging (especially US) guidance as compared with palpation-guided interventions with the limitation of heterogeneity of data and considerable RoB.

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Ultrasound‐Guided Biceps Tendon Sheath Injection: Spectrum of Preprocedure Appearances

Geannette

Williams

Berkowitz

et al. 2019

J of Ultrasound Medicine

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Objectives-To determine the frequency of ultrasound (US) appearances of the extra-articular long head of the proximal biceps tendon in patients referred for US-guided biceps tendon sheath injections.Methods-We reviewed our US-guided biceps tendon sheath injections between January 2015 and December 2017, noting the appearance of the biceps tendon and sheath, as well as the needle size used, and what was injected. Clinical electronic medical records were also reviewed to determine safety and patients' responses.Results-A total of 300 US-guided biceps tendon sheath injections were performed for anterior shoulder pain. Preliminary US evaluations revealed that 129 of 300 (43%) patients had a normal US appearance of the biceps tendon; 110 (36.6%) had tendinosis; 13 (4.3%) had tenosynovitis; 31 (10.3%) had both tendinosis and tenosynovitis; 8 (2.7%) had a biceps tendon tear; and 9 (3%) had a history of a tenodesis. Of 81 patients who had pain relief after the injection, 41 had a normal tendon appearance on US, and 40 had an abnormal US appearance.Conclusions-A large minority of patients with anterior shoulder pain clinically suspected to be due to the biceps tendon have a normal-appearing tendon and sheath. This should not dissuade the operator from performing the procedure.

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Comparison of Ultrasound‐Guided to Fluoroscopy‐Guided Biceps Tendon Sheath Therapeutic Injection

Cited by 22 publications

References 9 publications

Ultrasound-guided interventions for painful shoulder: from anatomy to evidence

Ultrasound-guided interventions for painful shoulder: from anatomy to evidence

Value of imaging to guide interventional procedures in rheumatic and musculoskeletal diseases: a systematic literature review informing EULAR points to consider

Ultrasound‐Guided Biceps Tendon Sheath Injection: Spectrum of Preprocedure Appearances

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