Accuracy and Efficacy of Ultrasound-Guided Glenohumeral Joint Injections
Bibliographic record
Abstract
OBJECTIVE: The aim of the study was to perform a systematic review comparing the accuracy and the efficacy of ultrasound-guided versus landmark-guided and other image-guided glenohumeral joint injections. METHODS: Embase, PubMed, Scopus, and Web of Science were searched up to June 24, 2023. Independent authors reviewed and selected qualifying randomized controlled studies, cohort studies, and case control/case series comparing either the accuracy and/or clinical efficacy of ultrasound-guided versus landmark-guided and other image-guided glenohumeral joint injections. Two independent authors extracted and synthesized the data. Quality appraisal of the studies was performed using the Cochrane Assessment of Bias tool (RoB2) and Newcastle-Ottawa Quality Assessment Scale, where applicable. RESULTS: A total of nine studies were included in the review, which included eight live human studies and one cadaveric study. Eight studies assessed for accuracy of ultrasound-guided glenohumeral joint injections. Cumulatively, there was a 63%-100% accuracy rate with ultrasound-guided injections compared with 40%-76.19% accuracy rate with blind injections and 72%-100% with fluoroscopic-guided injections. The accuracy rate of ultrasound-guided glenohumeral joint aspirations was 69.4% compared with the accuracy rate of other image-guided modalities, which was 70.6%. Three randomized control studies evaluated the efficacy of ultrasound-guided injections compared with landmark-guided injections by examining pain, range of motion, and function. All three studies did not show a statistically significant difference in the either group in all measures, although one study did show a statistically significant improvement in pain reduction sooner in the ultrasound-guided group. CONCLUSIONS: Ultrasound-guided glenohumeral joint injections are more accurate than landmark-guided injections and have similar accuracy rates compared with other imaging modalities. Ultrasound-guided injections are efficacious in treating glenohumeral joint disorders but not superior to landmark-guided injections. Future research should focus on standardized protocols, larger sample sizes, and long-term follow-up to obtain more robust evidence to determine the superiority of ultrasound-guided injections.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.048 | 0.204 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.010 |
| Bibliometrics | 0.010 | 0.007 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".