Physician Assistant Use of Ultrasound for Shoulder, Hip, and Knee Joint Injections

Background: Physician assistants (PAs) perform joint injections in the office setting. Although ultrasound (US) provides a safe option that increases accuracy of injections, this orthopedic specific training has not been routinely offered in PA education. The aim of this study was to examine the frequency with which orthopedic PAs performed shoulder, hip, and knee joint injections, with and without US, and how US training was obtained. Methods: In a quantitative descriptive cross-sectional study, PAs received a link to a self-designed survey by an email list provided by the physician assistants in orthopedic surgery. Results: Most PAs with access to US performed 10 or less shoulder, hip, and knee joint injections using US each month. The most common US training reported was on-the-job (n = 141; 35.30%), independent courses (n = 91; 22.80%), and self-taught (n = 70; 17.50%). Nearly one-half (n = 196; 49.00%) reported no US training, leading to 177 PAs (60.00%) perceiving they were not at all or only somewhat prepared to perform US in clinical practice. Conclusion: Overall, shoulder and knee joint injections were performed more often in the office than hip joint injections and were more commonly performed without US. Most PAs perceived they were not prepared to perform US in practice during their formal education, with many having sought further training.