Comparison of ultrasound- vs. landmark-guided injections for musculoskeletal pain: an umbrella review

Authors

  • Peng-Chieh Shen Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan City, Taiwan
  • Ting-Yu Lin Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan City, Taiwan
  • Wei-Ting Wu Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
  • Levent Özçakar Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
  • Ke-Vin Chang Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan

DOI:

https://doi.org/10.2340/jrm.v56.40769

Keywords:

Ultrasonography, anatomy, intervention, accuracy, symptom

Abstract

Objective: This umbrella review synthesizes systematic reviews and meta-analyses to reach a conclusion concerning the overall effectiveness of ultrasound-guided vs landmark-guided injections for treating musculoskeletal pain.

Design: Umbrella review.

Methods: PubMed, EMBASE, MEDLINE, and Web of Science were searched for relevant systematic reviews and meta-analyses from inception to March 2024. Critical appraisal, data extraction, and synthesis were performed in accordance with the criteria for conducting an umbrella review.

Results: Seventeen articles, comprising 4 systematic reviews and 13 meta-analyses, were included. Using the AMSTAR2 instrument for quality assessment, 3 articles were rated as high quality, 1 as moderate, 7 as low, and 6 as critically low. Generally, ultrasound-guided injections were found to be more accurate than landmark-guided injections, particularly in the shoulder joint, though the results for pain relief and functional outcomes varied. Ultrasound guidance was notably effective for injections into the bicipital groove, wrist, hip, and knee – yielding greater accuracy and improved pain management. Both ultrasound-guided and landmark-guided techniques showed low incidence of adverse effects.

Conclusion: This umbrella review offers an in-depth analysis of the comparative effectiveness of ultrasound-guided and landmark-guided injections across a range of musculoskeletal sites/conditions. The findings suggest that ultrasound-guided is a reliable method.

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2024-08-26

How to Cite

Shen, P.-C., Lin, T.-Y., Wu, W.-T., Özçakar , L., & Chang, K.-V. (2024). Comparison of ultrasound- vs. landmark-guided injections for musculoskeletal pain: an umbrella review. Journal of Rehabilitation Medicine, 56, jrm40679. https://doi.org/10.2340/jrm.v56.40769

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Vol. 56 (2024)

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Review

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Copyright (c) 2024 Peng-Chieh Shen, Ting-Yu Lin, Wei-Ting Wu, Levent Özçakar , Ke-Vin Chang

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