Are blind injections of gleno-humeral joint (GHJ) really less accurate imaging-guided injections? A narrative systematic review considering multiple anatomical approaches

La Radiologia medica
Paolo SimoniFréderic de Lemos Esteves

Abstract

To perform a systematic review to establish whether blind injections of the gleno-humeral (GHJ) joint may be an accurate alternative to injections performed imaging guidance, considering multiple anatomical approaches. Our search strategy yielded 478 articles for Scopus, 815 articles for MEDLINE, 128 articles for Cochrane Central Register of Controlled Trials and 555 articles for Embase until May 2016. One hundred and sixty-seven abstracts were retrieved after duplicates removal. Two readers independently reviewed all the 1067 abstracts. They selected for the full-text analysis only the abstracts in which the accuracy of intra-articular position of the needle was confirmed on imaging (humans) or by a surgical dissection (cadavers). Thirty-eight studies were eventually selected for the full-text reading and data extraction. The selected studies included a total of 2309 patients (2690 shoulders) and 195 cadavers (299 shoulders). To objectively assess the methodological quality of the present systematic review, "Assessment of Multiple Systematic Review" (AMSTAR) tool was used. The overall accuracy of the intra-articular injection in GHJ varied from 42 to 100% in the 38 selected studies. Imaging guidance was used in 65% of articles...Continue Reading

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