LEADER

Imaging

Do imaging methods that guide needle placement improve outcome?

S Hall¹, R Buchbinder²

¹ Department of Medicine, Monash University, Box Hill Hospital, and Cabrini Hospital, Melbourne, Australia
² Monash Department of Clinical Epidemiology at Cabrini Hospital; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia

Correspondence to:
Correspondence to:
Associate Professor R Buchbinder
Monash Department of Clinical Epidemiology, Suite 41 Cabrini Medical Centre, 183 Wattletree Rd, Malvern, Victoria, Australia 3144; rachelle.buchbinder@med.monash.edu.au

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For most joints injections following an anatomical landmark are sufficient

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Keywords: shoulder pain; imaging; suprascapular nerve block; corticosteroid injection

The first 150 words of the full text of this article appear below.

The year 1949 was a watershed for rheumatology. In that year Hench and his colleagues first described the use of corticosteroids for therapy in rheumatoid arthritis. Within a year Hollander and his colleagues, having seen the striking topical anti-inflammatory effects of cortisone, injected cortisone suspension into 25 knee joints inflamed by rheumatoid arthritis, but found only a minimal and transitory benefit.¹ However, by 1954, depot steroid preparations for intra-articular injection were part of the standard therapeutic armamentarium.¹

Despite the enthusiasm with which injected corticosteroids have been greeted and their widespread continued use, until recently, there has been limited evidence from controlled trials of their effectiveness in conditions such as shoulder disorders.² Furthermore, for the first 40 years of their use, the accuracy of needle placement was not methodically studied. In 1993, Jones et al studied the accuracy of 109 injections into various joints, by mixing the depot steroid with . . . [Full text of this article]

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• Naredo, E, Cabero, F, Cruz, A, Uson, J, Palop, M J, Crespo, M, Hall, S, Buchbinder, R (2005). Ultrasound guided musculoskeletal injections * Authors' reply. Ann Rheum Dis 64: 341-341 [Full Text]