title: American Medical Society for Sports Medicine (AMSSM) position statement: interventional musculoskeletal ultrasound in sports medicine.
abstract: BACKGROUND
  The use of diagnostic and interventional ultrasound has significantly increased over the past decade. A majority of the increased utilisation is by non-radiologists. In sports medicine, ultrasound is often used to guide interventions such as aspirations, diagnostic or therapeutic injections, tenotomies, releases and hydrodissections.
  
  
  OBJECTIVE
  Critically review the literature related to the accuracy, efficacy and cost-effectiveness of ultrasound-guided injections (USGIs) in major, intermediate and small joints; and soft tissues.
  
  
  METHODS
  Systematic review of the literature.
  
  
  RESULTS
  USGIs are more accurate than landmark-guided injections (LMGIs; strength of recommendation taxonomy (SORT) Evidence Rating=A). USGIs are more efficacious than LMGIs (SORT Evidence Rating=B). USGIs are more cost-effective than LMGIs (SORT Evidence Rating=B). Ultrasound guidance is required to perform many new procedures (SORT Evidence Rating=C).
  
  
  CONCLUSIONS
  The findings of this position statement indicate there is strong evidence that USGIs are more accurate than LMGI, moderate evidence that they are more efficacious and preliminary evidence that they are more cost-effective. Furthermore, ultrasound-guided (USG) is required to perform many new, advanced procedures and will likely enable the development of innovative USG surgical techniques in the future.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of California Davis School of Medicine, Sacramento, California, USA Department of Physical Medicine and Rehabilitation, Mayo Clinic college of Medicine, Mayo Clinic Sports Medicine Center, Rochester, Minnesota, USA.
authors.forename: Jonathan T
authors.initials: JT
authors.lastname: Finnoff
authors.affiliation: Department of Orthopedics and Rehabilitation, Department of Family Medicine, University of Iowa Sports Medicine, Iowa City, Iowa, USA.
authors.forename: Mederic M
authors.initials: MM
authors.lastname: Hall
authors.affiliation: Midwest Sports Medicine Institute, Middleton, Wisconsin, USA.
authors.forename: Erik
authors.initials: E
authors.lastname: Adams
authors.affiliation: Department of Orthopaedics and Emergency Medicine, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: David
authors.initials: D
authors.lastname: Berkoff
authors.affiliation: Outpatient Musculoskeletal Rehabilitation, St. Jude Medical Center, Fullerton, California, USA Department of Family Medicine, Division of Sports Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Concoff
authors.affiliation: Maine Medical Center, Portland, Maine, USA Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: William
authors.initials: W
authors.lastname: Dexter
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Mayo Clinic Sports Medicine Center, Rochester, Minnesota, USA Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Smith
mesh_terms: D003238:Connective Tissue / Q000000981:diagnostic imaging; D032921:Consensus; D003362:Cost-Benefit Analysis; D005544:Forecasting; D006801:Humans; D007267:Injections / Q000191:economics / Q000592:standards; D007270:Injections, Intra-Articular / Q000191:economics / Q000592:standards; D007596:Joints / Q000000981:diagnostic imaging; D009141:Musculoskeletal System / Q000000981:diagnostic imaging*; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging; D013178:Sports Medicine / Q000191:economics / Q000592:standards* / Q000639:trends; D018084:Ultrasonography, Interventional / Q000191:economics / Q000592:standards*
keywords: Intervention; Osteoarthritis; Sports medicine; Tendinopathy; Ultrasound