Ultrasound-guided hip joint injections are more accurate than landmark-guided injections: a systematic review and meta-analysis

Abstract

This is the first systematic review and meta-analysis of the accuracy of US-guided versus landmark-guided hip joint injections that has revealed that US-guided injections are significantly more accurate than those that are landmark guided. Future studies should compare US with fluoroscopic-guided hip joint injections for accuracy, efficacy, safety profile, cost-effectiveness and patient satisfaction.

Intra-articular hip injections: is there a role for ultrasound?

“…In a randomised, double-blind, controlled study of ultrasound-guided versus palpation-guided corticosteroid injection into various joints in patients with inflammatory arthritis, Cunnington et al 9 demonstrated that despite substantially improved accuracy with ultrasound guidance, short-term outcomes were not significantly different. This is contrasted by the AMSSM position paper3 that concluded moderate evidence for improved efficacy with ultrasound-guided injection, which highlights the need for further outcome-based studies. Safety factors should also be taken into account, as improved accuracy with US guidance may lead to reduced neurovascular injury, skin depigmentation, subcutaneous fat atrophy, intra-arterial injection, as well as pain and discomfort.…”

“…The AMSSM position paper3 concluded that there was preliminary evidence in favour of improved cost-effectiveness for ultrasound-guided injection for large joints and inflamed joints.…”

“…Comparisons of accuracy between these two methods, however, have not been directly evaluated. Hoeber et al ’s3 meta-analysis compares the accuracy of these two injection methods.…”

Role of Musculoskeletal Radiology in Modern Sports Medicine

“…The supremacy of ultrasound guidance over so-called blind injection techniques has been established at virtually all anatomical locations. [9][10][11][12] The use of ultrasound-guided injections in the athletic population is therefore increasing, most of which is attributed to nonradiologists, predominantly sports medicine physicians, 13 for whom ultrasoundguided procedures form an important part of formal training. 14 Radiologists, however, have a greater overall procedural foundation, including the use of other imaging modalities for guidance, that may be more suitable in certain anatomical locations.…”

Ultrasound Diagnostic and Therapeutic Injections of the Hip and Groin

“…A position statement by the American Medical Society for Sports Medicine reviewed the literature and found several level one studies of ultrasound guided hip injections with a mean accuracy of 99% [11]. In addition, a recent meta-analysis revealed that ultrasound-guided hip joint injections were significantly more accurate than landmark-guided intra-articular hip injections (accuracies were 100%, 95%CI 98–100%; 72%, 95%CI 56–85%, respectively) [12]. …”