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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.
- Source :
- European Radiology; Apr2020, Vol. 30 Issue 4, p2220-2230, 11p
- Publication Year :
- 2020
-
Abstract
- <bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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%).<bold>Conclusions: </bold>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.<bold>Key Points: </bold>• 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%). [ABSTRACT FROM AUTHOR]
- Subjects :
- MUSCULOSKELETAL system
CLINICAL indications
WRIST
ELBOW
TENOSYNOVITIS
GLUCOCORTICOIDS
PLATELET-rich plasma
ULTRASONIC imaging
TENOTOMY
INJECTIONS
INTERVENTIONAL radiology
RADIOGRAPHY
HYALURONIC acid
FLUOROSCOPY
DE Quervain disease
INTRA-articular injections
SOLUTION (Chemistry)
LONGITUDINAL method
DELPHI method
Subjects
Details
- Language :
- English
- ISSN :
- 09387994
- Volume :
- 30
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- European Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 142141873
- Full Text :
- https://doi.org/10.1007/s00330-019-06545-6