title: Ultrasound-guided hip joint injections are more accurate than landmark-guided injections: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To compare the accuracy of ultrasound (US)-guided versus landmark-guided hip joint injections.
  
  
  METHODS
  PubMed, Medline and Cochrane libraries were searched up to 31 July 2014. Two independent authors selected studies assessing accuracy of intra-articular hip injections based on predetermined inclusion and exclusion criteria. Selected papers were then evaluated for quality and a meta-analysis of accuracy was performed using random effects models.
  
  
  RESULTS
  4 US-guided (136 hip injections) and 5 landmark-guided (295 hip injections) studies were reviewed. The weighted means for US-guided and landmark-guided hip injection accuracies were 100% (95% CI 98% to 100%) and 72% (95% CI 56% to 85%), respectively. US-guided hip injection accuracy was significantly higher than landmark-guided accuracy (p<0.0001).
  
  
  CONCLUSIONS
  This is the first systematic review and meta-analysis of the accuracy of US-guided versus landmark-guided hip joint injections that has revealed that US-guided injections are significantly more accurate than those that are landmark guided. Future studies should compare US with fluoroscopic-guided hip joint injections for accuracy, efficacy, safety profile, cost-effectiveness and patient satisfaction.
authors.affiliation: Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Shane
authors.initials: S
authors.lastname: Hoeber
authors.affiliation: Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Abdel-Rahman
authors.initials: AR
authors.lastname: Aly
authors.affiliation: Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Nigel
authors.initials: N
authors.lastname: Ashworth
authors.affiliation: Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, Alberta, Canada Department of Orthopaedics and Rehabilitation, University of Iowa Sports Medicine, Iowa City, Iowa, USA.
authors.forename: Sathish
authors.initials: S
authors.lastname: Rajasekaran
mesh_terms: D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods*; D018084:Ultrasonography, Interventional
keywords: Hip; Ultrasound