@article{3121269,
    title = "Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—Part II, elbow and wrist",
    author = "Sconfienza, L.M. and Adriaensen, M. and Albano, D. and Aparisi Gómez, M.P. and Bazzocchi, A. and Beggs, I. and Bignotti, B. and Chianca, V. and Corazza, A. and Dalili, D. and De Dea, M. and del Cura, J.L. and Di Pietto, F. and Drakonaki, E. and Facal de Castro, F. and Filippiadis, D. and Gielen, J. and Gitto, S. and Gupta, H. and Klauser, A.S. and Lalam, R. and Martin, S. and Martinoli, C. and Mauri, G. and McCarthy, C. and McNally, E. and Melaki, K. and Messina, C. and Mirón Mombiela, R. and Neubauer, B. and Obradov, M. and Olchowy, C. and Orlandi, D. and Plagou, A. and Prada Gonzalez, R. and Rutkauskas, S. and Snoj, Z. and Tagliafico, A.S. and Talaska, A. and Vasilevska-Nikodinovska, V. and Vucetic, J. and Wilson, D. and Zaottini, F. and Zappia, M. and Allen, G. and on behalf of the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR)",
    journal = "European Radiology Experimental",
    year = "2020",
    volume = "30",
    number = "4",
    pages = "2220-2230",
    publisher = "Springer-Verlag",
    doi = "10.1007/s00330-019-06545-6",
    keywords = "hyaluronic acid;  steroid;  glucocorticoid;  hyaluronic acid;  viscosupplement, Article;  controlled study;  Delphi study;  elbow;  evidence based medicine;  joint function;  medical society;  metacarpophalangeal joint;  musculoskeletal procedure;  musculoskeletal system;  priority journal;  proximal interphalangeal joint;  recurrence risk;  rheumatoid arthritis;  trigger finger;  ultrasound;  wrist;  consensus development;  De Quervain tenosynovitis;  Delphi study;  epicondylitis;  fluoroscopy;  human;  injection;  interventional radiology;  interventional ultrasonography;  intraarticular drug administration;  prospective study;  radiography;  tenotomy;  thrombocyte rich plasma;  trigger finger, De Quervain Disease;  Delphi Technique;  Dry Needling;  Elbow Joint;  Elbow Tendinopathy;  Fluoroscopy;  Glucocorticoids;  Humans;  Hyaluronic Acid;  Injections;  Injections, Intra-Articular;  Platelet-Rich Plasma;  Prospective Studies;  Radiography;  Radiography, Interventional;  Tenotomy;  Trigger Finger Disorder;  Ultrasonography, Interventional;  Viscosupplements;  Wrist Joint",
    abstract = "Background: Although 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. Methods: A 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. Results: Eighteen 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%). Conclusions: There 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%). © 2019, European Society of Radiology."
}