Table 1

Studies comparing different imaging techniques or imaging vs palpation guidance in large joints and periarticular structures (PICO1)

Year authorStudy designImagingComparatorDiseaseNo Imaging/
Comparator
Intervention (COMPOUND)SITEFAVORS imaging*FAVORS comparator*No difference between imaging and comparator*RoB†
US vs palpation guidance
2017
Raeissadat20
RCTUSPalpation guidanceAdhesive capsulitis20/21Injection
(contrast medium, triamcinolone, lidocaine)
shoulder joint1 x Efficacy (1,4 w)1 x Accuracy (BSL)
2 x Safety (BSL,1,4w)
5 x Efficacy (BSL,1,4w)
Embedded Image
2009
Lee30
RCTUSPalpation guidanceAdhesive capsulitis20/20injection
(triamcinolone, lidocaine, saline hyaluronic acid)
shoulder joint2 x Safety (1,2 w)
5 x Efficacy (1,2,3,4 w)
Embedded Image
2014
Saeed21
RCTUSPalpation guidanceShoulder impingement41/39injection
(methylprednisolone, lidocaine)
glenohumeral joint, biceps tendon sheath, AC joint)1 x Safety (6,12 w)
2 x Efficacy (6,12 w)
1 x Efficacy (12 w)Embedded Image
2004
Naredo33
RCTUSPalpation guidancePeriarticular shoulder disorders21/20injection
(triamcinolone)
SA-SD bursa1 x Accuracy (BSL)
1 x Safety (6 w)
1 x Efficacy (6 w)
1 x Safety (BSL)Embedded ImageEmbedded Image
2011
Hashiuchi29
RCTUSPalpation guidanceAnterior shoulder pain15/15injection
(contrast agent)
biceps tendon sheath1 x Accuracy (BSL)Embedded Image
2011
Zhang27
RCTUSPalpation guidanceBiceps brachii tendinitis53/45injection
(lidocaine, triamcinolone)
brachial bicipital groove1 x Safety (n.a.)
2 x Efficacy (n.a.)
1 x Safety (n.a.)
1 x Efficacy (n.a.)
Embedded Image
2019 Yiannakopoulos58RCTUSPalpation guidanceTendinosis of the long head of the biceps22/22injection (triamcinolone, bupivacaine)long biceps tendon1 x Accuracy (BSL)
1 x Safety (BSL,4w,6m)
2 x Efficacy (4 w,6m)
1 x Cost/Time (BSL)
1 x Safety (up to 6 m)Embedded Image
2014
Chang22
RCTUSPalpation guidanceScapular pain18/18injection
(triamcinolone, lidocaine)
subscapularis muscle2 x Safety (BSL,1,2,3w,3m)
1 x Efficacy (1 w,3m)
Embedded Image
2013
Kim23
RCTUSPalpation guidanceElbow OA40/40Injection
(dexamethasone, lidocaine, contrast medium)
Elbow joint1 x Accuracy (BSL)Embedded Image
2008
Luz32
RCT
(letter)
USPalpation guidanceRA with wrist synovitis30/30injection
(lidocaine, triamcinolone, contrast medium, air)
wrist joint1 x Accuracy (BSL)
2 x Safety (BSL,1,4,8,12w)
1 x Efficacy (BSL,1,4,8,12w)
Embedded Image
2018
Mitchell19
RCTUSPalpation guidanceTrochanteric bursitis15/15injection
(lidocaine, methylprednisolone)
Trochanteric bursa1 x Safety (6 m)1 x Cost/Time (n.a.)1 x Safety (n.a.)
2 x Efficacy (6 m,12 m)
Embedded Image
2011
Sibbitt28
RCTUSPalpation guidanceKnee OA46/46injection
(Xylocaine, triamcinolone)
knee joint1 x Safety (BSL,2w,6m)
1 x Efficacy (BSL to 6 m)
1 x Cost/Time (BSL to 12 m)1 x Efficacy (BSL to 12 m)
1 x Cost/Time (BSL to 12 m)
Embedded Image
2011
Bum Park, 26
RCTUSPalpation guidanceKnee OA50/49injection
(hyaluronic acid, contrast dye)
knee joint1 x Accuracy (BSL)Embedded Image
2013
Jang24
RCTUSPalpation guidanceKnee joint OA41/44/41injection
(lidocaine, triamcinolone, contrast agent)
knee joint1 x Accuracy (BSL)
1 x Safety (BSL)
1 x Cost/Time (BSL)Embedded Image
2020 Cankurtaran55RCTUSPalpation guidanceChronic knee OA11/12injection (triamcinolone, lidocaine)knee joint2 x Efficacy (1,3 m)3 x Efficacy (3 m)2 x Safety (BSL,1m,3m)
6 x Efficacy (1 m,3m)
Embedded Image
2012
Sibbitt25
RCTUSPalpation guidanceKnee effusion42/22aspiration, injection
(lidocaine, triamcinolone)
knee joint2 x Accuracy (BSL)
1 x Safety (BSL,2w)
Embedded Image
2009
Im31
RCTUSPalpation guidanceKnee joint OA45/44injection
(Hyaluronic acid, contrast dye)
knee joint1 x Accuracy (BSL)Embedded Image
2019
Lundstrom18
Retrospective cohort studyUSPalpation guidanceReceiving knee injection500/647injection
(hyaluronic acid formulas)
knee joint2 x Efficacy (up to 6y)1 x Efficacy (up to 6 y)Embedded Image
2020
Sheth57
RCTUSPalpation guidanceReceiving knee injection19/18aspiration and injection (depomedrol, lidocaine)knee joint1 x Safety (BSL,4–6 w)
6 x Efficacy (BSL,4–6 w)
Embedded Image
2019
Lee56
RCTUSPalpation guidancePes anserinus tendinobursitis27/27injection (triamcinolone, lidocaine)Pes anserinus bursa1 x Accuracy (BSL)
1 x Safety (BSL,1,4w)
1 x Safety (up to 4 w)Embedded Image
US vs fluoroscopy
2016 Petscavage-Thomas14Retrospective cohort studyUSFluo.Anterior shoulder pain51/50injection
(triamcinolone, lidocaine)
biceps tendon sheath1 x Accuracy (BSL)2 x Safety (1–3 m,n.a.)
1 x Cost/Time (n.a.)
Embedded Image
2014
Fowler16
RCTUSFluo.Piriformis syndrome15/12injection, nerve stimulation
(lidocaine, triamcinolone)
piriformis muscle2 x Safety (BSL,1,2w,3m)
2 x Efficacy (BSL,1,2w,3m)
1 x Cost/Time (BSL,1,2w,3m)
Embedded Image
2016
Soneji13
RCTUSFluo.Chronic SIJ arthritis20/20injection
(methylprednisolone, bupivacaine, epinephrine)
SIJ1 x Cost/Time (BSL)1 x Accuracy (BSL)
2 x Safety (BSL,1,3d,1w,1,3m)
2 x Efficacy (BSL, 1 m)
Embedded Image
2014
Jee15
RCTUSFluo.Non-inflamm.
SIJ dysfunction
55/55injection
(contrast media, lidocaine, dexamethasone)
SIJ1 x Accuracy (BSL)2 x Safety (BSL,2,12w)
2 x Efficacy (BSL,2,12w)
Embedded ImageEmbedded Image
2019
Kim12
RCTUSFluo.Chronic knee OA38/33injection, genicular nerve block
(lidocaine, triamcinolone)
knee joint2 x Safety (BSL,3,6m)
5 x Efficacy (BSL,3,6m)
Embedded Image
US/fluoroscopy vs palpation guidance
2016
Bossert17
Retro spective cross sectional
study
Fluo./USPalpation guidanceAnkle OA29/9/12injection
(viscosupplement)
ankle2 x Efficacy (BSL, n.a.)1 x Safety (n.a.)
3 x Efficacy (n.a.)
Embedded Image
Fluoroscopy vs palpation guidance
2019 Cohen53RCTFluo.Palpation guidancepainful SIJ64/61injection (depomethylprednisolone, bupivacaine)SIJ1 x Accuracy (BSL)
2 x Safety (1,3 m)
3 x Safety (BSL,1,3m)
4 x Efficacy (BSL,1,3m)
Embedded Image
US vs fluoroscopy vs palpation guidance
2020
Henne59
Retrospective cohort studyFluo.US, Palpation guidanceHip OA or FAI302 855injection
(corticosteroid,or hyaluronic acid)
Hip2 x Cost/Time (post-procedure)Embedded Image
Fluoroscopy vs CT
2020 Diffre54retrospective cohort studyFluo.CTpyogenic vertebral osteomyelitis51/37Biopsydisco-vertebral tissue1 x Accuracy (BSL)1 x Safety (n.a.)Embedded Image
  • *These columns indicate the number of outcomes studied and their categories (eg, 6 × efficacy indicates that six different outcomes related to the efficacy category were studied), with the respective time point(s) when the outcome was determined (parenthesis). The term ‘BSL’ refers to differences concerning the outcomes at BL. A detailed description of studies and outcomes can be found in supplement.

  • †A green, yellow, red and black circle indicate low, moderate, high and critical risk of bias, respectively. In case multiple circles are depicted, certain outcomes within one study had different risk of bias.

  • BSL, baseline; FAI, femoroacetabular impingement; n.a., not applicable; OA, osteoarthritis; PICO, Population, Intervention, Comparator, Outcome; RA, rheumatoid arthritis; RCT, randomised controlled trial; RoB, Risk of Bias; SA-SD, subacromial-subdeltoid bursa; SIJ, sacroiliac joint(s); US, ultrasound.;