Ultrasound-Guided Steroid Injections for Shoulder Pain

Evidence-Based Answer Ultrasound-guided glucocorticoid injection for shoulder pain provides no advantage over landmark-guided or intramuscular injection in terms of pain, function, range of motion, or safety when measured within a six-week follow-up period. Only one study was assessed to have a low risk of bias; it compared ultrasound-guided subacromial injection with systemic gluteal injection.2 No differences in pain or function were noted between groups during a six-week follow-up, suggesting that any benefit of the injection was likely from its systemic effects and not dependent on injection location. In a letter to the editor following the gluteal injection controlled study, a critic questioned the validity of rotator cuff disease as a specific disease entity and asked how a subacromial injection could possibly reach all affected tendons and problem areas.3 A recent review discusses the most useful techniques for accurately diagnosing rotator cuff disease.4 Future studies should address glenohumeral arthritis (such cases were largely excluded from this meta-analysis).