Ultrasound- Versus Landmark-Guided Corticosteroid Injections in Patients With Shoulder Pain: A Meta-Analysis and Systematic Review.

Abstract

This meta-analysis evaluated the effects of ultrasound-guided (USG) and landmark-guided (LMG) injections of corticosteroids into the shoulder joint cavity of patients with shoulder pain. The PubMed database was searched for articles (January 1, 2004-December 31, 2023) comparing USG and LMG injections of corticosteroids for the treatment of adult shoulder pain. Two authors independently performed data extraction and appraisal. The outcome measures collected were visual analogue scale (VAS) score and VAS score change at 1 and 6 weeks postinjection and range of motion (ROM) at 6 weeks postinjection. Thirteen studies including 656 patients were reviewed (USG and LMG groups, 328 patients each). The VAS score at 1 week postinjection and the ROM in abduction at 6 weeks postinjection were statistically different, but there were no statistically significant differences in other outcomes. This meta-analysis indicated that USG corticosteroid injection may have a better effect than LMG corticosteroid injection for early-stage shoulder pain and abduction in the mid- to long-term, but does not affect later shoulder pain or other ROMs.