TY - JOUR
TI - 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
AU - Sconfienza, L.M.
AU - Adriaensen, M.
AU - Albano, D.
AU - Aparisi Gómez, M.P.
AU - Bazzocchi, A.
AU - Beggs, I.
AU - Bignotti, B.
AU - Chianca, V.
AU - Corazza, A.
AU - Dalili, D.
AU - De Dea, M.
AU - del Cura, J.L.
AU - Di Pietto, F.
AU - Drakonaki, E.
AU - Facal de Castro, F.
AU - Filippiadis, D.
AU - Gielen, J.
AU - Gitto, S.
AU - Gupta, H.
AU - Klauser, A.S.
AU - Lalam, R.
AU - Martin, S.
AU - Martinoli, C.
AU - Mauri, G.
AU - McCarthy, C.
AU - McNally, E.
AU - Melaki, K.
AU - Messina, C.
AU - Mirón Mombiela, R.
AU - Neubauer, B.
AU - Obradov, M.
AU - Olchowy, C.
AU - Orlandi, D.
AU - Plagou, A.
AU - Prada Gonzalez, R.
AU - Rutkauskas, S.
AU - Snoj, Z.
AU - Tagliafico, A.S.
AU - Talaska, A.
AU - Vasilevska-Nikodinovska, V.
AU - Vucetic, J.
AU - Wilson, D.
AU - Zaottini, F.
AU - Zappia, M.
AU - Allen, G.
AU - on behalf of the Ultrasound
AU - Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR)
JO - European Radiology Experimental
PY - 2020
VL - 30
TODO - 4
SP - 2220-2230
PB - Springer-Verlag
SN - null
TODO - 10.1007/s00330-019-06545-6
TODO - 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
TODO - 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.
ER -