Bibliometric Analysis of the 50 Most-Cited Articles on Ultrasound-Guided Minimally Invasive Procedures of the Upper Limb

BACKGROUND: Ultrasound-guided minimally invasive procedures have rapidly emerged as an alternative to open or endoscopic surgery for several upper-limb conditions, including carpal tunnel syndrome, trigger finger, lateral epicondylitis, and calcific tendinitis of the rotator cuff. To our knowledge, no bibliometric analysis dedicated to this field has been published. OBJECTIVE: This study aimed to characterize the 50 most-cited articles on ultrasound-guided minimally invasive procedures of the upper limb. METHODS: A search of the Web of Science Core Collection was performed on May 17, 2026. The query combined ultrasound guidance terms with terms covering upper-limb procedures (hand, wrist, elbow, shoulder). After document type and English-language filters, articles were sorted by citation count, and two independent reviewers screened the top 200 records, excluding pure injections without a mechanical component. Bibliometric data, level of evidence, and thematic categories were extracted. RESULTS: The 50 included articles accumulated 2,078 citations (mean 41.6 ± 22.8; range 20-107) and were published between 2005 and 2023. The Journal of Ultrasound in Medicine was the most prolific (10%); European countries collectively contributed 50% of articles (notably Spain 12% and Italy 10%), while the United States accounted for 22%. Sixty-two percent were Level IV-V evidence; 32% provided Level I-II evidence. The dominant themes were carpal tunnel release (32%) and barbotage for calcific tendinitis (28%). CONCLUSIONS: This bibliometric analysis highlights two dominant clusters (carpal tunnel release, calcific tendinitis) and a 32% rate of Level I-II evidence, higher than typically reported in surgical bibliometric analyses.