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Ultrasound-guided hip joint injections are more accurate than landmark-guided injections: a systematic review and meta-analysis
  1. Shane Hoeber1,
  2. Abdel-Rahman Aly1,
  3. Nigel Ashworth1,
  4. Sathish Rajasekaran1,2
  1. 1Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Alberta, Canada
  2. 2Department of Orthopaedics and Rehabilitation, University of Iowa Sports Medicine, Iowa City, Iowa, USA
  1. Correspondence to Dr Sathish Rajasekaran, Department of Orthopaedics and Rehabilitation, University of Iowa Sports Medicine, 2701 Prairie Meadow Drive, Iowa City, IA 52242, USA; sathish.k.rajasekaran{at}


Aim To compare the accuracy of ultrasound (US)-guided versus landmark-guided hip joint injections.

Methods PubMed, Medline and Cochrane libraries were searched up to 31 July 2014. Two independent authors selected studies assessing accuracy of intra-articular hip injections based on predetermined inclusion and exclusion criteria. Selected papers were then evaluated for quality and a meta-analysis of accuracy was performed using random effects models.

Results 4 US-guided (136 hip injections) and 5 landmark-guided (295 hip injections) studies were reviewed. The weighted means for US-guided and landmark-guided hip injection accuracies were 100% (95% CI 98% to 100%) and 72% (95% CI 56% to 85%), respectively. US-guided hip injection accuracy was significantly higher than landmark-guided accuracy (p<0.0001).

Summary This is the first systematic review and meta-analysis of the accuracy of US-guided versus landmark-guided hip joint injections that has revealed that US-guided injections are significantly more accurate than those that are landmark guided. Future studies should compare US with fluoroscopic-guided hip joint injections for accuracy, efficacy, safety profile, cost-effectiveness and patient satisfaction.

  • Ultrasound
  • Hip

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