Comparison of ultrasound-guided to fluoroscopy-guided biceps tendon sheath therapeutic injection

Jonelle Thomas, Cristy Gustas

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives-Biceps tendinitis is a source of anterior shoulder pain and is amenable to therapeutic injection. Studies have shown greater accuracy with image-guided compared to unguided injection of the biceps tendon sheath. There is no literature comparing ultrasound-guided to fluoroscopy-guided biceps tendon sheath injection. The purpose of this study was to compare clinical outcomes, complication rates, procedure success rates, and financial costs of the two imaging-guided methods. Methods-A 10-year retrospective review of the picture archiving and communication system was performed to identify patients who underwent image-guided proximal biceps tendon sheath injection. Two radiologists reviewed the picture archiving and communication system and clinical notes to record pain relief, complications, fluoroscopy time, first-pass success rate (defined as injection into the sheath on the first needle pass), final success rate (needle placement in the tendon sheath on the final needle pass), and average costs. Results-Fifty fluoroscopy-guided and 53 ultrasound-guided cases were identified. There was no statistically significant difference in pain relief or complications. The first-pass success rate was 90.6% for ultrasound compared to 74.0% for fluoroscopy. The finalpass success rate was 98.2% for ultrasound versus 92.0% for fluoroscopy. The mean fluoroscopy time was 57.6 seconds. Ultrasound showed preinjection abnormalities of the biceps tendon in 47.5% of cases. Conclusions-Compared to fluoroscopy-guided biceps tendon sheath injection, ultrasound had higher initial- and final-pass success rates, visualized abnormalities before injection, and had similar pain relief and complication rates. Ultrasound is more accurate and has greater diagnostic benefits than unguided or fluoroscopy-guided biceps tendon sheath injection.

Original languageEnglish (US)
Pages (from-to)2217-2221
Number of pages5
JournalJournal of Ultrasound in Medicine
Volume35
Issue number10
DOIs
StatePublished - Oct 1 2016

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Fluoroscopy
Tendons
Injections
Radiology Information Systems
Needles
Therapeutics
Pain
Costs and Cost Analysis
Tendinopathy
Shoulder Pain
antineoplaston A10

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Comparison of ultrasound-guided to fluoroscopy-guided biceps tendon sheath therapeutic injection",
abstract = "Objectives-Biceps tendinitis is a source of anterior shoulder pain and is amenable to therapeutic injection. Studies have shown greater accuracy with image-guided compared to unguided injection of the biceps tendon sheath. There is no literature comparing ultrasound-guided to fluoroscopy-guided biceps tendon sheath injection. The purpose of this study was to compare clinical outcomes, complication rates, procedure success rates, and financial costs of the two imaging-guided methods. Methods-A 10-year retrospective review of the picture archiving and communication system was performed to identify patients who underwent image-guided proximal biceps tendon sheath injection. Two radiologists reviewed the picture archiving and communication system and clinical notes to record pain relief, complications, fluoroscopy time, first-pass success rate (defined as injection into the sheath on the first needle pass), final success rate (needle placement in the tendon sheath on the final needle pass), and average costs. Results-Fifty fluoroscopy-guided and 53 ultrasound-guided cases were identified. There was no statistically significant difference in pain relief or complications. The first-pass success rate was 90.6{\%} for ultrasound compared to 74.0{\%} for fluoroscopy. The finalpass success rate was 98.2{\%} for ultrasound versus 92.0{\%} for fluoroscopy. The mean fluoroscopy time was 57.6 seconds. Ultrasound showed preinjection abnormalities of the biceps tendon in 47.5{\%} of cases. Conclusions-Compared to fluoroscopy-guided biceps tendon sheath injection, ultrasound had higher initial- and final-pass success rates, visualized abnormalities before injection, and had similar pain relief and complication rates. Ultrasound is more accurate and has greater diagnostic benefits than unguided or fluoroscopy-guided biceps tendon sheath injection.",
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Comparison of ultrasound-guided to fluoroscopy-guided biceps tendon sheath therapeutic injection. / Thomas, Jonelle; Gustas, Cristy.

In: Journal of Ultrasound in Medicine, Vol. 35, No. 10, 01.10.2016, p. 2217-2221.

Research output: Contribution to journalArticle

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AU - Gustas, Cristy

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N2 - Objectives-Biceps tendinitis is a source of anterior shoulder pain and is amenable to therapeutic injection. Studies have shown greater accuracy with image-guided compared to unguided injection of the biceps tendon sheath. There is no literature comparing ultrasound-guided to fluoroscopy-guided biceps tendon sheath injection. The purpose of this study was to compare clinical outcomes, complication rates, procedure success rates, and financial costs of the two imaging-guided methods. Methods-A 10-year retrospective review of the picture archiving and communication system was performed to identify patients who underwent image-guided proximal biceps tendon sheath injection. Two radiologists reviewed the picture archiving and communication system and clinical notes to record pain relief, complications, fluoroscopy time, first-pass success rate (defined as injection into the sheath on the first needle pass), final success rate (needle placement in the tendon sheath on the final needle pass), and average costs. Results-Fifty fluoroscopy-guided and 53 ultrasound-guided cases were identified. There was no statistically significant difference in pain relief or complications. The first-pass success rate was 90.6% for ultrasound compared to 74.0% for fluoroscopy. The finalpass success rate was 98.2% for ultrasound versus 92.0% for fluoroscopy. The mean fluoroscopy time was 57.6 seconds. Ultrasound showed preinjection abnormalities of the biceps tendon in 47.5% of cases. Conclusions-Compared to fluoroscopy-guided biceps tendon sheath injection, ultrasound had higher initial- and final-pass success rates, visualized abnormalities before injection, and had similar pain relief and complication rates. Ultrasound is more accurate and has greater diagnostic benefits than unguided or fluoroscopy-guided biceps tendon sheath injection.

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