A systematic review and meta-analysis on the use of diagnostic ultrasound in guiding corticosteroid injections for shoulder pain (subacromial/ subdeltoid bursa)

Authors

  • Aamir Safdar Khan Department of Rheumatology, Worcester Acute Hospitals, Worcester, England
  • Munir Khan Department of Pain Management, Alton Pain Clinic, Alton, England
  • Muhammad Siddiqui Department of Population Health, Saskatchewan Health Authority, Saskatoon, Canada
  • Amna Aamir Khan Ziauddin College of Rehabilitation Sciences, Ziauddin University, Karachi, Pakistan
  • Mubarra Rao Independent Consultant, Karachi, Pakistan

DOI:

https://doi.org/10.47391/JPMA.25-20274

Keywords:

Ultrasonography, Interventional ultrasound, Shoulder pain, Corticosteroids, Shoulder impingement syndromes

Abstract

Objective: To assess the efficacy of diagnostic ultrasound-guided corticosteroid injections in subacromial/subdeltoid bursa in the management of shoulder pain.

Method: The systematic review and meta-analysis was conducted from November 2023 to February 2024 in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, and comprised search on Cochrane Central Register of Controlled Trials, Excerpta Medica dataBASE, Scopus and PubMed databases for randomised controlled and/or clinical trials involving adult patients with shoulder pain/subacromial impingement/bursitis, comparing ultrasound-guided corticosteroid injections versus blind injections, and published in the English language between January 2003 and August 2023. Quality assessment was performed using the Physiotherapy Evidence Database scale, and meta-analysis was performed using MedCalc software.

Results: Of the 72 full-text articles assessed, 11(15.3%) were analysed. There was a definite short-term effectiveness of ultrasound-guided corticosteroid injections in reducing pain, as assessed by visual analogue scale scores (p <0.001 at 6 weeks; p<0.05 at 12 week and 33 week) and improved range of motion in flexion, abduction, internal and external rotation (p<0.001-0.05). While meta-analysis confirms significant pooled effects for pain scores and range of motion outcomes at 6 weeks, long-term efficacy remained inconclusive due to heterogeneity across studies and limited long-term follow-up research on the subject.

Conclusion: Evidence supported short-term efficacy of ultrasound-guided corticosteroid injections for shoulder pain management, but robust trials with extended follow-up periods and larger cohorts are needed to establish their long-term effectiveness.

Key Words: Ultrasonography, Interventional ultrasound, Shoulder pain, Corticosteroids, Shoulder impingement syndromes.

Published

2025-11-22

How to Cite

Aamir Safdar Khan, Munir Khan, Muhammad Siddiqui, Amna Aamir Khan, & Mubarra Rao. (2025). A systematic review and meta-analysis on the use of diagnostic ultrasound in guiding corticosteroid injections for shoulder pain (subacromial/ subdeltoid bursa). Journal of the Pakistan Medical Association, 75(12), 1937–1947. https://doi.org/10.47391/JPMA.25-20274

Issue

Section

SYSTEMATIC REVIEWS