Ultrasound-Guided Arthrocentesis in the Emergency Department: A Scoping Review (2013-2023)

The objective of this scoping review is to map and describe the current scope of research on ultrasound-guided arthrocentesis (UGA) in the emergency department (ED), assess methodological quality, summarise procedural techniques and identify evidence gaps.

Joint aspiration or arthrocentesis procedures are commonly performed in the ED to diagnose and manage painful joints with effusions. The integration of ultrasound technology into arthrocentesis has improved patient care and reduced complications.

This scoping review examined all articles in the English language published in the ED settings between January 2013 and December 2023. We included human studies in peer-reviewed journals.

PubMed, Ovid MEDLINE, Embase, Cochrane CENTRAL, ClinicalTrials.gov and OpenGreyEU, searched 1 January 2013 to 31 December 2023 (last run: 18 April 2024). Reference lists hand-searched.

We applied PRISMA ScR guidelines and Joanna Briggs Institute (JBI) guidelines for this scoping review. A medical librarian constructed a robust and replicable search strategy for contemporary literature in key clinical databases. We registered the protocol in the Open Science Framework (OSF). In addition, we performed a screening of titles, abstracts and full texts through www.rayyan.ai in collaboration with the reviewers. Two reviewers performed screening and data charting independently, with any discordance reviewed by a third investigator.

During the initial screening, we found 255 articles. After removal of duplicates, we found 182 abstracts for further screening. We identified 30 articles following the abstract screening. We performed a rigorous screening of these 30 full-text articles and included 11 articles for the final review. We found the majority of these articles were case reports (n = 5, 45%) and case series (n = 3, 27%). There was only one randomised controlled trial. Most of the research (n = 8, 73%) was conducted in the USA, which limits the generalisability of the research findings. A significant research gap has been identified, which opens the avenues for future research in this field.

This scoping review highlights that while UGA is increasingly used in ED settings, the available contemporaneous evidence is limited and heterogeneous. A significant research gap in the scoping review warrants larger, higher quality studies to establish standardised practices and assess clinical outcomes.