Clinical utility of ultrasound guidance for intra-articular knee injections: a review

David J Berkoff1, Larry E Miller2,3, Jon E Block31Department of Orthopedics, University of North Carolina School of Medicine, Chapel Hill, NC; 2Miller Scientific Consulting Inc, Arden, NC; 3The Jon Block Group, San Francisco, CA, USAAbstract: Intra-articular corticosteroid and hyaluronic acid inject...

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Autores principales:	Berkoff DJ, Miller LE, Block JE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	injection intraarticular knee ultrasound Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/df48d06d0ed643739889072a64ec512c
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spelling	oai:doaj.org-article:df48d06d0ed643739889072a64ec512c2021-12-02T00:44:03ZClinical utility of ultrasound guidance for intra-articular knee injections: a review1178-1998https://doaj.org/article/df48d06d0ed643739889072a64ec512c2012-03-01T00:00:00Zhttps://www.dovepress.com/clinical-utility-of-ultrasound-guidance-for-intra-articular-knee-injec-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998David J Berkoff1, Larry E Miller2,3, Jon E Block31Department of Orthopedics, University of North Carolina School of Medicine, Chapel Hill, NC; 2Miller Scientific Consulting Inc, Arden, NC; 3The Jon Block Group, San Francisco, CA, USAAbstract: Intra-articular corticosteroid and hyaluronic acid injections provide short-term symptom amelioration for arthritic conditions involving structural damage or degenerative changes in the knee. Conventional palpation-guided anatomical injections frequently result in inaccurate needle placement into extra-articular tissue and adjacent structures. The purpose of this review was to determine the effect of ultrasound guidance on the accuracy of needle placement, clinical outcomes, and cost-effectiveness in comparison with anatomical landmark-guided intra-articular large joint injections, with particular emphasis on the knee. A total of 13 relevant studies were identified; five studied the knee, seven studied the shoulder, one used both the knee and shoulder, and none studied the hip. Ultrasound was used in seven studies; the remaining studies utilized air arthrography, fluoroscopy, magnetic resonance arthrography, or magnetic resonance imaging. Across all studies (using all imaging modalities and all joints), needle placement accuracy ranged from 63% to 100% with ultrasound and from 39% to 100% with conventional anatomical guidance. Imaging guidance improved the accuracy of intra-articular injections of the knee (96.7% versus 81.0%, P < 0.001) and shoulder (97.3% versus 65.4%, P < 0.001). In particular, ultrasound guidance of knee injections resulted in better accuracy than anatomical guidance (95.8% versus 77.8%, P < 0.001), yielding an odds ratio of 6.4 (95% confidence interval 2.9–14). Ultrasound guidance notably improves injection accuracy in the target intra-articular joint space of large joints including the knee. The enhanced injection accuracy achieved with ultrasound needle guidance directly improves patient-reported clinical outcomes and cost-effectiveness.Keywords: injection, intra-articular, knee, ultrasoundBerkoff DJMiller LEBlock JEDove Medical PressarticleinjectionintraarticularkneeultrasoundGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 7, Pp 89-95 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	injection intraarticular knee ultrasound Geriatrics RC952-954.6
spellingShingle	injection intraarticular knee ultrasound Geriatrics RC952-954.6 Berkoff DJ Miller LE Block JE Clinical utility of ultrasound guidance for intra-articular knee injections: a review
description	David J Berkoff1, Larry E Miller2,3, Jon E Block31Department of Orthopedics, University of North Carolina School of Medicine, Chapel Hill, NC; 2Miller Scientific Consulting Inc, Arden, NC; 3The Jon Block Group, San Francisco, CA, USAAbstract: Intra-articular corticosteroid and hyaluronic acid injections provide short-term symptom amelioration for arthritic conditions involving structural damage or degenerative changes in the knee. Conventional palpation-guided anatomical injections frequently result in inaccurate needle placement into extra-articular tissue and adjacent structures. The purpose of this review was to determine the effect of ultrasound guidance on the accuracy of needle placement, clinical outcomes, and cost-effectiveness in comparison with anatomical landmark-guided intra-articular large joint injections, with particular emphasis on the knee. A total of 13 relevant studies were identified; five studied the knee, seven studied the shoulder, one used both the knee and shoulder, and none studied the hip. Ultrasound was used in seven studies; the remaining studies utilized air arthrography, fluoroscopy, magnetic resonance arthrography, or magnetic resonance imaging. Across all studies (using all imaging modalities and all joints), needle placement accuracy ranged from 63% to 100% with ultrasound and from 39% to 100% with conventional anatomical guidance. Imaging guidance improved the accuracy of intra-articular injections of the knee (96.7% versus 81.0%, P < 0.001) and shoulder (97.3% versus 65.4%, P < 0.001). In particular, ultrasound guidance of knee injections resulted in better accuracy than anatomical guidance (95.8% versus 77.8%, P < 0.001), yielding an odds ratio of 6.4 (95% confidence interval 2.9–14). Ultrasound guidance notably improves injection accuracy in the target intra-articular joint space of large joints including the knee. The enhanced injection accuracy achieved with ultrasound needle guidance directly improves patient-reported clinical outcomes and cost-effectiveness.Keywords: injection, intra-articular, knee, ultrasound
format	article
author	Berkoff DJ Miller LE Block JE
author_facet	Berkoff DJ Miller LE Block JE
author_sort	Berkoff DJ
title	Clinical utility of ultrasound guidance for intra-articular knee injections: a review
title_short	Clinical utility of ultrasound guidance for intra-articular knee injections: a review
title_full	Clinical utility of ultrasound guidance for intra-articular knee injections: a review
title_fullStr	Clinical utility of ultrasound guidance for intra-articular knee injections: a review
title_full_unstemmed	Clinical utility of ultrasound guidance for intra-articular knee injections: a review
title_sort	clinical utility of ultrasound guidance for intra-articular knee injections: a review
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/df48d06d0ed643739889072a64ec512c
work_keys_str_mv	AT berkoffdj clinicalutilityofultrasoundguidanceforintraarticularkneeinjectionsareview AT millerle clinicalutilityofultrasoundguidanceforintraarticularkneeinjectionsareview AT blockje clinicalutilityofultrasoundguidanceforintraarticularkneeinjectionsareview
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Clinical utility of ultrasound guidance for intra-articular knee injections: a review

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