Table 2

Summary table for studies comparing the accuracy of US-guided injections to landmark-guided injections

ParticipantsInjectate/approach
Efficacy studiesUSLMUSLMOutcomesFU intervalsReported efficacy of US-guided injections
Subacromial space
 Ucuncu et al25 RCT60 patients with shoulder pain1 mL 40 mg triamcinolone
1 mL 1% lidocaine
Primary outcome:
  • 1. Pain VAS

  • 2.  CS

0, 6 week(+) For VAS and CS at 6 weeks
3030IPLateralSecondary outcomes:
  • 3. Active/passive shoulder flexion and abduction

  • 4. Early and late stage injection side effects

 Chen et al26 RCT40 patients with US confirmation of subacromial bursitis1 mL of β-methasone
1 mL of 1% lidocaine
Primary outcome:
  • 1. Shoulder abduction ROM

0, 1 week(+) For ROM at 1 week
2020Lateral (IP)Lateral
 Zufferey et al27
Observer blind RCT
70 patients with shoulder pain
67 patients completed the study
2 mL of 7 mg of 1/3 soluble and 2/3 long-acting β-methasonePrimary outcome:
  • 1. Pain NRS

  • 2. Shoulder ROM and modified CS

  • 3. Patients with ≥50% of improvement

0, 2, 6, 12 week(+) For VAS at 2 and 6 weeks
(−) For modified CS and ROM
3235Not explainedNot explainedSecondary outcome:
  • 4. Use of other analgesic medications

  • 5. side effects

 Dogu et al28
Double blind RCT
46 patients with subacromial impingement syndrome1 mL β-methasone dipropionate
9 mL prilocaine hydrochloride
0.02 mL gadolinium
  • 1. Pain VAS during rest, activity and sleep

  • 2. Constant general pain score

  • 3. Constant ROM score

  • 4. Constant ADLs score

  • 5. Shoulder Disability Questionnaire

  • 6. Adverse effects

  • 7. Accuracy

0, 6 weeks(−) For all parameters
2323Lateral IPPosterior
 Hsieh et al29
Observer blind RCT
96 patients with shoulder pain
92 patients completed the study
0.5 mL dexamethasone
3 mL lidocaine
Primary outcome:
  • 1. Pain VAS

  • 2.  Active/passive ROM

0, 1, 4 weeks(+) For passive shoulder abduction
(+) For physical functioning and vitality scores on the SF-36
(−) For all the other parameters
4646Lateral IPLateralSecondary outcome:
  • 3. SPADI

  • 4. SDQ

  • 5. 36 item SF Health Survey SF-36

 Naredo et al30
Observer blind RCT
41 patients with periarticular disorders of the shoulder20 mg triamcinolone
  • 1. Pain VAS overall, activity and night

  • 2. Presence of nocturnal pain

  • 3. SFA scale

  • 4. Intake of NSAID

  • 5. Patients with a ≥50% improvement SFA/VAS

  • 6. The active and passive ROM

  • 7. Postinjection adverse effects

0, 6 weeks(+) For VAS and the SFA score
2021IPLateral
Biceps tendon sheath
 Zhang et al31
Observer blind RCT
98 patients with biceps tendinitis1 mL triamcinolone
1 mL lidocaine
  • 1. Pain VAS

  • 2. CMS

0, Q 4 weeks(+) For VAS and CMS
5345lateral IPlateral
GH Joint
 Lee et al32
Double-blind RCT
43 patients with adhesive capsulitis
40 patients completed the study
0.5 mL triamcinolone (20 mg)
1.5 mL of 2% lidocaine
3 mL of normal saline
Primary outcome:
  • 1. Pain VAS in the daytime and night time

  • 2. Passive shoulder ROM

  • 3. FAS

0, 1, 2, 3, 4, 5, 6 weeks(+) for all parameters at 2 weeks
(−) for all parameters at 6 weeks
2020Posterior (IP)Posterior
  • AC, acromioclavicular; ADLs, activities of daily living; CMS, Constant-Murley score; CS, constant scale; FAS, Functional activities of the shoulder score; FU, follow-up; GH, glenohumeral; IP, in plane; LM, landmark; NSAID, non-steroidal anti-inflammatory drugs; NRS, Numerical Rating Scale; RCT, randomised clinical trial; ROM, range of motion; SDQ, Shoulder Disability Questionnaire; SFA, Shoulder Function Assessment; SPADI, Shoulder Pain and Disability Index; SF, Short-Form; US, ultrasound; VAS, Visual Analogue Scale.

  • (+)=significantly greater improvement in the US group compared to the Landmark group.

  • (−)=no significant difference between the US and Landmark groups.