Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-12-16

AUTHORS

Luca Maria Sconfienza, Miraude Adriaensen, Domenico Albano, Maria Pilar Aparisi Gómez, Alberto Bazzocchi, Ian Beggs, Bianca Bignotti, Vito Chianca, Angelo Corazza, Danoob Dalili, Miriam De Dea, Jose Luis del Cura, Francesco Di Pietto, Eleni Drakonaki, Fernando Facal de Castro, Dimitrios Filippiadis, Jan Gielen, Salvatore Gitto, Harun Gupta, Andrea S. Klauser, Radhesh Lalam, Silvia Martin, Carlo Martinoli, Giovanni Mauri, Catherine McCarthy, Eugene McNally, Kalliopi Melaki, Carmelo Messina, Rebeca Mirón Mombiela, Benedikt Neubauer, Marina Obradov, Cyprian Olchowy, Davide Orlandi, Athena Plagou, Raquel Prada Gonzalez, Saulius Rutkauskas, Ziga Snoj, Alberto Stefano Tagliafico, Alexander Talaska, Violeta Vasilevska-Nikodinovska, Jelena Vucetic, David Wilson, Federico Zaottini, Marcello Zappia, Georgina Allen

ABSTRACT

BackgroundAlthough image-guided interventional procedures of the elbow and wrist are routinely performed, there is poor evidence in the literature concerning such treatments. Our aim was to perform a Delphi-based consensus on published evidence on image-guided interventional procedures around the elbow and wrist and provide clinical indications on this topic.MethodsA board of 45 experts in image-guided interventional musculoskeletal procedures from the European Society of Musculoskeletal Radiology were involved in this Delphi-based consensus study. All panelists reviewed and scored published papers on image-guided interventional procedures around the elbow and wrist updated to September 2018 according to the Oxford Centre for Evidence-based Medicine levels of evidence. Consensus on statements drafted by the panelists about clinical indications was considered as “strong” when more than 95% of panelists agreed and as “broad” if more than 80% agreed.ResultsEighteen statements were drafted, 12 about tendon procedures and 6 about intra-articular procedures. Only statement #15 reached the highest level of evidence (ultrasound-guided steroid wrist injections result in greater pain reduction and greater likelihood of attaining clinically important improvement). Seventeen statements received strong consensus (94%), while one received broad consensus (6%).ConclusionsThere is still poor evidence in published papers on image-guided interventional procedures around the elbow and wrist. A strong consensus has been achieved in 17/18 (94%) statements provided by the panel on clinical indications. Large prospective randomized trials are needed to better define the role of these procedures in clinical practice.Key Points• The panel provided 18 evidence-based statements on clinical indications of image-guided interventional procedures around the elbow and wrist.• Only statement #15 reached the highest level of evidence: ultrasound-guided steroid wrist injections result in greater pain reduction and greater likelihood of attaining clinically important improvement.• Seventeen statements received strong consensus (94%), while broad consensus was obtained by 1 statement (6%). More... »

PAGES

2220-2230

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  • Journal

    TITLE

    European Radiology

    ISSUE

    4

    VOLUME

    30

    Author Affiliations

  • Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20100, Milan, Italy
  • Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, The Netherlands
  • Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy
  • Department of Radiology, Hospital Vithas Nueve de Octubre, 46015, Valencia, Spain
  • Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy
  • Department of Radiology, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
  • Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genova, Italy
  • IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy
  • Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
  • The Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK
  • UOC Radiologia, Ospedale di Feltre, AULSS1 Dolomiti, Veneto, Italy
  • University of the Basque Country (UPV/EHU), Leioa, Spain
  • Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, CE, Italy
  • Department of Anatomy, Medical School of the European University of Cyprus, Nicosia, Cyprus
  • Department of Radiology, General University Hospital of Valencia, Valencia, Spain
  • 2nd Department of Radiology, University General Hospital “ATTIKON”, Medical School, National and Kapodistrian University of Athens, Athens, Greece
  • University of Antwerp Hospital (UZA), Antwerp, Belgium
  • Università degli Studi di Milano, Milan, Italy
  • Leeds Teaching Hospitals, Leeds, UK
  • Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
  • The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, UK
  • Medicine, Universidad de las Islas Baleares, Palma de Mallorca, Spain
  • Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy
  • Oxford Musculoskeletal Radiology, Oxford, UK
  • Medical School of the National and Kapodistrian University of Athens, Athens, Greece
  • Radiologisk Afdeling, Herlev og Gentofte Hospital, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark
  • Ordensklinkum Linz, Linz, Austria
  • Sint Maartenskliniek, Nijmegen, The Netherlands
  • Department of Oral Surgery, Wroclaw Medical University, Wroclaw, Poland
  • Department of Radiology, Ospedale Evangelico Internazionale Genova, Genova, Italy
  • Department of Radiology, Private Institution of Ultrasonography, Athens, Greece
  • Department of Radiology, Hospital POVISA, Vigo, Spain
  • Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
  • University Medical Centre Ljubljana, Zaloška ul. 7, 1000, Ljubljana, Slovenia
  • Department of Radiology, AUVA Trauma Centre, Vienna, Austria
  • Medical Faculty, University “Ss.Cyril and Methodius”, University Surgical Clinic “St.Naum Ohridski”, Skopje, North Macedonia
  • Oxford University, Oxford, UK
  • DISSAL Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genova, Italy
  • Varelli Institute, Naples, Italy
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00330-019-06545-6

    DOI

    http://dx.doi.org/10.1007/s00330-019-06545-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1123439338

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/31844963


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