Observation of Images During Ultrasound-Guided Procedures Improves the Patient Experience

Background Intra-articular and soft tissue steroid injections are common procedures in Rheumatology and are taking the place of fluoroscopic or CT-guidance injection. However, little is known about patient views on ultrasound-guided steroid injections and whether observing images during the procedure has a positive or negative impact. Objectives We conducted a pilot study to quantitatively describe patients' view of US-guided procedures. Methods 50 survey questionnaires with balanced-likert scales were distributed to Rheumatology patients who underwent an US-guided procedure in the Rheumatology Department at Sandwell and West Birmingham Hospitals NHS Trust between January 2011 and January 2012. All patients were able to view the scanner screen and the procedure and images were explained by the operator. Survey receipt was concluded in April 2012 relating to a post injection period ranging between 4–16 months. Of 50 questionnaires distributed, 30 (60%) were returned and 26 (50%) were completed and included for data analysis. Results A total of 33 joints/tendon regions were injected in 26 patients [12; hand, 9; wrist, 2; elbow, 3; knee, 5; feet]. All patients felt that observing the US images during the US-guided procedure was helpful. 85% of the patients felt that observing US images during the procedure reduced anxiety with no individuals describing heightened anxiety. 92% of patients felt that observing the US images in real-time helped them to tolerate the procedure better and the same proportion of patients felt seeing the images increased their confidence that the pain source had been identified. 62% of patients felt that observing the US images provides additional information that improves understanding of the procedure. Amongst those who had a non-guided injection previously (n=19), 68% of patients felt that US-guided injection was more or much more effective compared to traditional injection without US. Conclusions Observing images during US-guided procedure improves patients' experience and has no negative impact.