A systematic review and meta-analysis on the use of diagnostic ultrasound in guiding corticosteroid injections for shoulder pain (subacromial/ subdeltoid bursa)
Bibliographic record
Abstract
OBJECTIVE: To assess the efficacy of diagnostic ultrasound-guided corticosteroid injections in subacromial/subdeltoid bursa in the management of shoulder pain. Methods: The systematic review and meta-analysis was conducted from November 2023 to February 2024 in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, and comprised search on Cochrane Central Register of Controlled Trials, Excerpta Medica dataBASE, Scopus and PubMed databases for randomised controlled and/or clinical trials involving adult patients with shoulder pain/subacromial impingement/bursitis, comparing ultrasound-guided corticosteroid injections versus blind injections, and published in the English language between January 2003 and August 2023. Quality assessment was performed using the Physiotherapy Evidence Database scale, and meta-analysis was performed using MedCalc software. RESULTS: Of the 72 full-text articles assessed, 11(15.3%) were analysed. There was a definite short-term effectiveness of ultrasound-guided corticosteroid injections in reducing pain, as assessed by visual analogue scale scores (p <0.001 at 6 weeks; p<0.05 at 12 week and 33 week) and improved range of motion in flexion, abduction, internal and external rotation (p<0.001-0.05). While meta-analysis confirms significant pooled effects for pain scores and range of motion outcomes at 6 weeks, long-term efficacy remained inconclusive due to heterogeneity across studies and limited long-term follow-up research on the subject. Conclusion: Evidence supported short-term efficacy of ultrasound-guided corticosteroid injections for shoulder pain management, but robust trials with extended followup periods and larger cohorts are needed to establish their long-term effectiveness.
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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 | 0.022 | 0.053 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.023 | 0.041 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".