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      Open Access: True


Article Info

DATE

2021-09-28

AUTHORS

Luca Maria Sconfienza, Miraude Adriaensen, Domenico Albano, Andrea Alcala-Galiano, Georgina Allen, Maria Pilar Aparisi Gómez, Giacomo Aringhieri, Alberto Bazzocchi, Ian Beggs, Vito Chianca, Angelo Corazza, Danoob Dalili, Miriam De Dea, Jose Luis del Cura, Francesco Di Pietto, Elena Drakonaki, Fernando Facal de Castro, Dimitrios Filippiadis, Salvatore Gitto, Andrew J. Grainger, Simon Greenwood, Harun Gupta, Slavcho Ivanoski, Monica Khanna, Andrea Klauser, Ramy Mansour, Silvia Martin, Vasco Mascarenhas, Giovanni Mauri, Catherine McCarthy, David McKean, Eugene McNally, Kalliopi Melaki, Carmelo Messina, Rebeca Miron Mombiela, Ricardo Moutinho, Cyprian Olchowy, Davide Orlandi, Raquel Prada González, Mahesh Prakash, Magdalena Posadzy, Saulius Rutkauskas, Žiga Snoj, Alberto Stefano Tagliafico, Alexander Talaska, Xavier Tomas, Violeta Vasilevska Nikodinovska, Jelena Vucetic, David Wilson, Federico Zaottini, Marcello Zappia, Amanda Isaac

ABSTRACT

ObjectivesTo perform a Delphi-based consensus on published evidence on image-guided interventional procedures for peripheral nerves of the lower limb (excluding Morton’s neuroma) and provide clinical indications.MethodsWe report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around peripheral nerves in the lower limb (excluding Morton’s neuroma) to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper.ResultsNine statements on image-guided interventional procedures for peripheral nerves of the lower limb have been drafted. All of them received strong consensus. Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia.ConclusionDespite the promising results reported by published papers on image-guided interventional procedures for peripheral nerves of the lower limb, there is still a lack of evidence on the efficacy of most procedures.Key Points• Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications.• US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role.• US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia. The volume of local anesthetic affects the size of the blocked sensory area. More... »

PAGES

1-9

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  • Journal

    TITLE

    European Radiology

    ISSUE

    N/A

    VOLUME

    N/A

    Author Affiliations

  • Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Riccardo Galeazzi 4, 20161, 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, Palermo, Italy
  • Hospital Universitario, 12 de Octubre, Madrid, Spain
  • University of Oxford, Oxford, UK
  • Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
  • Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
  • Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  • Analytic Imaging, Edinburgh, UK
  • Clinica Di Radiologia EOC IIMSI, Lugano, Switzerland
  • IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
  • South West London Elective Orthopaedic Centre (SWLEOC), Epsom & St Helier University Hospitals NHS Trust, London, UK
  • Studio MSK, Belluno, Italy
  • Hospital Universitario Donostia, San Sebastian, Spain
  • Dipartimento Di Diagnostica Per Immagini, Pineta Grande Hospital, Castel Volturno, Italy
  • MSK Radiology Services, Heraklion, Crete, Greece
  • Hospital General Universitario de Valencia, Valencia, Spain
  • 2nd Department of Radiology, University General Hospital “ATTIKON” Medical School, National and Kapodistrian University of Athens, Haidari/Athens, Greece
  • Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Milan, Italy
  • Cambridge University Hospitals, Cambridge, UK
  • Mid Cheshire Hospitals NHS Foundation Trust, Cheshire, UK
  • Leeds Teaching Hospitals, Leeds, UK
  • Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
  • Imperial College Healthcare NHS Trust, London, UK
  • Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
  • Oxford Musculoskeletal Radiology, Oxford University Hospitals, Oxford, UK
  • Hospital Universitario Son Llatzer, Palma, Spain
  • AIRC, Advanced imaging research consortium, Lisbon, Portugal
  • Division of Interventional Radiology, Istituto Europeo Di Oncologia, Milan, Italy
  • Oxford Musculoskeletal Radiology, Oxford, UK
  • Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
  • Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • Department of Radiology, Herlev og Gentofte Hospital, Herlev, Denmark
  • Hospital de Loulé, Loulé, Portugal
  • Department of Oral Surgery, Wroclaw Medical University, Wroclaw, Poland
  • Department of Radiology, Ospedale Evangelico Internazionale, Genoa, Italy
  • Hospital POVISA, Vigo, Spain
  • Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
  • Indywidualna Praktyka Lekarska Magdalena Posadzy, Poznan, Poland
  • Department of Radiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
  • Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
  • IRCCS Ospedale Policlinico San Martino, Genova, Italy
  • Department of Radiology, AUVA Trauma Center Vienna, Vienna, Austria
  • Radiology Dpt. MSK Unit. Hospital Clinic (CDIC), University of Barcelona (UB), Barcelona, Spain
  • Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
  • Radiology Department, Hospital ICOT Ciudad de Telde, Las Palmas, Spain
  • St Luke’s Radiology Oxford Ltd, Oxford, UK
  • Guy’s and St Thomas’ Hospitals, London, UK
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00330-021-08283-0

    DOI

    http://dx.doi.org/10.1007/s00330-021-08283-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1141452472

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34581843


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