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.


Journal

European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 16 07 2019
accepted: 27 09 2019
revised: 30 08 2019
pubmed: 13 11 2019
medline: 22 9 2020
entrez: 13 11 2019
Statut: ppublish

Résumé

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. 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. 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%). 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. • 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%).

Sections du résumé

BACKGROUND 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 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 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 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 CONCLUSIONS
• 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%).

Identifiants

pubmed: 31712960
doi: 10.1007/s00330-019-06479-z
pii: 10.1007/s00330-019-06479-z
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1498-1506

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Auteurs

Luca Maria Sconfienza (LM)

IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy. io@lucasconfienza.it.
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy. io@lucasconfienza.it.

Miraude Adriaensen (M)

Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, The Netherlands.

Domenico Albano (D)

IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy.
Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy.

Georgina Allen (G)

St Luke's Radiology Oxford Ltd, Oxford, UK.
University of Oxford, Oxford, UK.

Maria Pilar Aparisi Gómez (MP)

Department of Radiology, Auckland City Hospital, Auckland, 1023, New Zealand.
Department of Radiology, Hospital Vithas Nueve de Octubre, 46015, Valencia, Spain.

Alberto Bazzocchi (A)

Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy.

Ian Beggs (I)

Department of Radiology, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK.

Bianca Bignotti (B)

Ospedale Policlinico San Martino, 16132, Genoa, Italy.

Vito Chianca (V)

IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy.

Angelo Corazza (A)

IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy.

Danoob Dalili (D)

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
The Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK.

Miriam De Dea (M)

UOC Radiologia, Ospedale di Feltre, AULSS1 Dolomiti, Veneto, Italy.

Jose Luis Del Cura (JL)

Department of Radiology, Donostia University Hospital, 20014, Donostia/San Sebastian, Spain.
University of the Basque Country (UPV/EHU), Leioa, Spain.

Francesco Di Pietto (F)

Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, (CE), Italy.

Eleni Drakonaki (E)

Private Institution of Ultrasonography and MSK Radiology, Heraklion, Greece.
Department of Anatomy, Medical School of the European University of Cyprus, Engomi, Cyprus.

Fernando Facal de Castro (F)

IBERORAD 1895 S.L., 08021, Barcelona, Spain.
Department of Radiology, General University Hospital of Valencia, Valencia, Spain.

Dimitrios Filippiadis (D)

2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Jan Gielen (J)

University of Antwerp, Antwerp, Belgium.
University of Antwerp Hospital (UZA), Edegem, Belgium.

Salvatore Gitto (S)

Università degli Studi di Milano, Milan, Italy.

Harun Gupta (H)

Leeds Teaching Hospitals, Leeds, UK.

Andrea S Klauser (AS)

Medical University Innsbruck, Innsbruck, Austria.
Department of Radiology, Innsbruck, Austria.

Radhesh Lalam (R)

The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, UK.

Silvia Martin (S)

Hospital Son Llatzer, Palma de Mallorca, Spain.
Universidad de las Islas Baleares Medicine, Palma, Balearic Islands, Spain.

Carlo Martinoli (C)

Ospedale Policlinico San Martino, 16132, Genoa, Italy.
University of Genoa - DISSAL Department of Health Sciences, Genoa, Italy.

Giovanni Mauri (G)

Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy.

Catherine McCarthy (C)

The Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK.
Oxford Musculoskeletal Radiology, Oxford, UK.

Eugene McNally (E)

Oxford Musculoskeletal Radiology, Oxford, UK.

Kalliopi Melaki (K)

Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Carmelo Messina (C)

IRCCS Istituto Ortopedico Galeazzi, 20161, Milano, Italy.
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy.

Rebeca Mirón Mombiela (R)

Department of Physiology, Universidad de Valencia/INCLIVA, 46010, Valencia, Spain.
Herlev og Gentofte Hospital Radiologisk Afdeling, Herlev Ringvej 75, opgang 51, Herlev, Denmark.

Benedikt Neubauer (B)

Radiology, Medical University of Vienna, Vienna, Austria.
Ordensklinikum Linz, Linz, Austria.

Marina Obradov (M)

Sint Maartenskliniek, 9011, Nijmegen, 6500GM, The Netherlands.

Cyprian Olchowy (C)

Department of Oral Surgery, Wroclaw Medical University, Wrocław, Poland.

Davide Orlandi (D)

Ospedale Evangelico Internazionale Genova, Genoa, Italy.

Raquel Prada Gonzalez (RP)

Department of Radiology, Hospital POVISA, Vigo, Spain.

Saulius Rutkauskas (S)

Radiology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Ziga Snoj (Z)

Department of Radiology, University Medical Centre Ljubljana, Zaloška 7, Ljubljana, 1000, Slovenia.

Alberto Stefano Tagliafico (AS)

Ospedale Policlinico San Martino, 16132, Genoa, Italy.
Department of Health Sciences, University of Genoa, 16132, Genoa, Italy.

Alexander Talaska (A)

Department of Radiology, AUVA Trauma Centre, Vienna, Austria.

Violeta Vasilevska-Nikodinovska (V)

Medical Faculty, University "Ss.Cyril and Methodius", Skopje, North Macedonia.
University Surgical Clinic "St.Naum Ohridski", Skopje, North Macedonia.

Jelena Vucetic (J)

Department of Radiology, General University Hospital of Valencia, Valencia, Spain.
Department of Physiology, Universidad de Valencia/INCLIVA, 46010, Valencia, Spain.

David Wilson (D)

St Luke's Radiology Oxford Ltd, Oxford, UK.
University of Oxford, Oxford, UK.

Federico Zaottini (F)

University of Genoa - DISSAL Department of Health Sciences, Genoa, Italy.

Marcello Zappia (M)

Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
Varelli Institute, Naples, Italy.

Athena Plagou (A)

Department of Radiology, Private Institution of Ultrasonography, Athens, Greece.

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