Background: Ultrasonography is an increasingly valuable tool for the diagnosis and treatment of musculoskeletal disorders. In the past, ultrasound has been used for diagnostic purposes, with increasing use of image guidance for joint injections.
Hypothesis: Ultrasound-guided intraarticular native nontraumatic hip injections are equally as accurate with less cost as other diagnostic imaging modalities including fluoroscopicguided injections.
Design: This analysis was based on a meta-analysis of the accuracy of the different imaging modalities. Initially a search was performed for intraarticular hip injections in PubMed, Embase, and ClinicalTrials.gov. Injection accuracy rates between groups were analyzed via proportional meta-analysis. For the economic analysis, compensation data were determined from estimated charges from Duke University Medical Center.
Results: Compared with gold standards of accurate injections (such as fluoroscopic and computed tomography-guided injections), ultrasound is 97% as accurate (confidence interval 93%, 99%). Based on 2014 reimbursement data, reimbursement for large-joint intraarticular injection averages $61.99 (37.38£, 47.18€) ($49.20-$76.31). Fluoroscopic global reimbursement averages $105.32 (63.51£, 80.13€) ($76.75-$134.72). Ultrasound guidance global reimbursement averages $75.99 (45.86£, 57.83€) ($57.95-$93.15).
Conclusion: Ultrasound-guided hip injections are an accurate technique for alleviating hip pain at less cost. In an era of increasing concern for health care expenditures, finding an accurate, effective, and cost-friendly alternative has the potential for widespread adaptation and practice.
Keywords: Accuracy, Cost analysis, Guided injections, Musculoskeletal ultrasound.
How to cite this article:Porras L, Boggess B. Economic Analysis of Accuracy and Cost of Ultrasound-guided Intraarticular Hip Injections. The Duke Orthop J 2016;6(1):35-40.
Source of support: The Duke University Internal Medicine Research Grant funded this study.
Conflict of interest: Dr Boggess maintains industry relationships with GE, SonoSite, Bioventus, and Arthrex although none provided funding. For the remaining authors none were declared.