Accuracy of shoulder joint injections with ultrasound guidance:Confirmed by magnetic resonance arthrography  

作　　者：Kosuke Kuratani Makoto Tanaka Hiroto Hanai Kenji Hayashida 

机构地区：[1]Department of Orthopedic Surgery,Japan Community Healthcare Organization Osaka Hospital,Osaka 553-0003,Japan [2]Center for Sports Medicine,Daini Osaka Police Hospital,Osaka 543-8922,Japan [3]Department of Orthopaedic Surgery,Osaka University Graduate School of Medicine,Suita 565-0871,Japan [4]Department of Orthopaedic Surgery,Daini Osaka Police Hospital,Osaka 543-8922,Japan

出　　处：《World Journal of Orthopedics》2022年第3期259-266,共8页世界骨科杂志（英文版）

摘　　要：BACKGROUND Intra-articular glenohumeral joint injections are essential procedures for treating various shoulder disorders. Fluoroscopy-guided injections have been extensively used;however, they pose a risk of radiation exposure and are expensive and timeconsuming. Recently, it has been suggested that ultrasound-guided injections are accurate and cost effective procedures.AIM To evaluate the accuracy of ultrasound-guided glenohumeral injections using a posterior approach that is confirmed using magnetic resonance arthrography(MRA).METHODS The study included 179 shoulders of patients with recurrent anterior instability(150 patients;103 and 76 right and left shoulders, respectively;160 males and 19 females;average age = 20.5 years;age range: 14-63 years) who underwent MRA for preoperative diagnosis. They were injected with 12 m L lidocaine(1%) using the ultrasound-guided posterior approach and then underwent magnetic resonance imaging. Two shoulder surgeons, except for the injector, evaluated the transverse relaxation(T2)-weighted images of axial planes and classified the intraarticular condition of injected contrast into three groups based on one of the three following scenarios: no leakage, injection into the glenohumeral joint without leakage;minor leakage, practical intra-articular injection with some leakage outside the posterior rotator cuffs;and major leakage, inaccurate injection with mass leakage without any contrast into the joint. The inter-rater reliability between two assessors was also evaluated by calculating Cohen’s kappa coefficient. The learning curve was assessed regarding the inaccurate injection rate by analyzing Spearman’s rank correlation coefficient.RESULTS Of the 179 injections, 163 shoulders(91.0%) had no leakage, 10 shoulders(5.6%) had minor leakage, and six shoulders(3.4%) had major leakage. In total, 173 shoulders(96.6%) were intraarticularly injected;thus, we could detect anterior labrum and capsular pathologies. Regarding the inter-rater reliability, the kappa coefficient was 0.925

关 键 词：Shoulder injections Glenohumeral injections Ultrasound guidance Magnetic resonance arthrography 

分 类 号：R445.2[医药卫生—影像医学与核医学] R684[医药卫生—诊断学]