@article{3121354,
    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 III, nerves of the upper limb",
    author = "Sconfienza, L.M. and Adriaensen, M. and Albano, D. and Allen, G. 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 Gonzalez, R.P. 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 Plagou, A. 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 = "3",
    pages = "1498-1506",
    publisher = "Springer-Verlag",
    doi = "10.1007/s00330-019-06479-z",
    keywords = "corticosteroid, Article;  brachial plexus anesthesia;  carpal tunnel syndrome;  cubital tunnel syndrome;  echography;  evidence based medicine;  human;  interventional ultrasonography;  low level laser therapy;  medical society;  musculoskeletal system;  priority journal;  upper limb;  carpal tunnel syndrome;  computer assisted surgery;  consensus;  Delphi study;  diagnostic imaging;  echography;  innervation;  medical society;  peripheral nerve;  procedures;  radiography;  radiology, Carpal Tunnel Syndrome;  Consensus;  Delphi Technique;  Humans;  Peripheral Nerves;  Radiography;  Radiology;  Societies, Medical;  Surgery, Computer-Assisted;  Ultrasonography;  Upper Extremity",
    abstract = "Background: Image-guided interventional procedures of the nerves are commonly performed by physicians from different medical specialties, although there is a lack of clinical indications for these types of procedures. This Delphi-based consensus provided a list of indications on image-guided interventional procedures for nerves of the upper limb based on updated published evidence. Methods: An expert panel of 45 members of the Ultrasound and Interventional Subcommittees of the ESSR participated in this Delphi-based consensus study. After revision of the published papers on image-guided interventional procedures for nerves of the upper limb updated to September 2018, the experts drafted a list of statements according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus on statements regarding clinical indications was considered as strong when more than 95% of experts agreed, and broad if more than 80% agreed. Results: Ten statements were drafted on procedures for nerves of the upper limb. Only two statements reached the highest level of evidence (ultrasound guidance is a safe and effective method for brachial plexus block; ultrasound-guided non-surgical approaches are safe and effective methods to treat carpal tunnel syndrome in the short term, but there is sparse evidence on the mid- and long-term effectiveness of these interventions). Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%). Conclusions: This Delphi-based consensus study reported poor evidence on image-guided interventional procedures for nerves of the upper limb. Sixty percent of statements on clinical indications provided by the expert board reached a strong consensus. Key Points: • An expert panel of the ESSR provided 10 evidence-based statements on clinical indications for image-guided interventional procedures for nerves of the upper limb • Two statements reached the highest level of evidence • Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%) © 2019, European Society of Radiology."
}