Περίληψη:
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.
Συγγραφείς:
Sconfienza, L.M.
Adriaensen, M.
Albano, D.
Aparisi Gómez, M.P.
Bazzocchi, A.
Beggs, I.
Bignotti, B.
Chianca, V.
Corazza, A.
Dalili, D.
De Dea, M.
del Cura, J.L.
Di Pietto, F.
Drakonaki, E.
Facal de Castro, F.
Filippiadis, D.
Gielen, J.
Gitto, S.
Gupta, H.
Klauser, A.S.
Lalam, R.
Martin, S.
Martinoli, C.
Mauri, G.
McCarthy, C.
McNally, E.
Melaki, K.
Messina, C.
Mirón Mombiela, R.
Neubauer, B.
Obradov, M.
Olchowy, C.
Orlandi, D.
Plagou, A.
Prada Gonzalez, R.
Rutkauskas, S.
Snoj, Z.
Tagliafico, A.S.
Talaska, A.
Vasilevska-Nikodinovska, V.
Vucetic, J.
Wilson, D.
Zaottini, F.
Zappia, M.
Allen, G.
on behalf of the Ultrasound
Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR)
Λέξεις-κλειδιά:
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
