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.

De Quervain Disease / therapy Delphi Technique Dry Needling Elbow Joint Elbow Tendinopathy / therapy Fluoroscopy Glucocorticoids / administration & dosage Humans Hyaluronic Acid / administration & dosage Injections Injections, Intra-Articular Platelet-Rich Plasma Prospective Studies Radiography Radiography, Interventional Tenotomy Trigger Finger Disorder / therapy Ultrasonography, Interventional Viscosupplements / administration & dosage Wrist Joint
Elbow Injections Radiology, interventional Ultrasonography Wrist

Journal

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

Informations de publication

Date de publication:
Apr 2020
Historique:
received: 17 07 2019
accepted: 23 10 2019
revised: 20 09 2019
pubmed: 18 12 2019
medline: 21 10 2020
entrez: 18 12 2019
Statut: ppublish

Résumé

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. 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. 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%). 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. • 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%).

Sections du résumé

BACKGROUND 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 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 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 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 CONCLUSIONS
• 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%).

Identifiants

DOI: 10.1007/s00330-019-06545-6 PMID: 31844963
pubmed: 31844963
doi: 10.1007/s00330-019-06545-6
pii: 10.1007/s00330-019-06545-6
doi:

Substances chimiques

Glucocorticoids 0
Viscosupplements 0
Hyaluronic Acid 9004-61-9

Types de publication

Consensus Development Conference Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2220-2230

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Yamamoto M, Kurimoto S, Okui N, Tatebe M, Shinohara T, Hirata H (2012) Sonography-guided arthroscopy for wrist ganglion. J Hand Surg Am 37:1411–1415. https://doi.org/10.1016/j.jhsa.2012.04.012
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Auteurs

Luca Maria Sconfienza (LM)

IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy. io@lucasconfienza.it.
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20100, Milan, Italy. io@lucasconfienza.it.
ORCID: 0000-0003-0759-8431

Miraude Adriaensen (M)

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

Domenico Albano (D)

IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.
Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy.

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, Via G. C. Pupilli 1, 40136, Bologna, Italy.

Ian Beggs (I)

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

Bianca Bignotti (B)

Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genova, Italy.

Vito Chianca (V)

IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.

Angelo Corazza (A)

IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, 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, Begiristain Doktorea Pasealekua, 109, 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, Nicosia, 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), Antwerp, Belgium.

Salvatore Gitto (S)

Università degli Studi di Milano, Milan, Italy.

Harun Gupta (H)

Leeds Teaching Hospitals, Leeds, UK.

Andrea S Klauser (AS)

Department of Radiology, Medical University Innsbruck, 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.
Medicine, Universidad de las Islas Baleares, Palma de Mallorca, Spain.

Carlo Martinoli (C)

DISSAL Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genova, Italy.
Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genova, 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)

Medical School of the National and Kapodistrian University of Athens, Athens, Greece.

Carmelo Messina (C)

IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20100, Milan, Italy.

Rebeca Mirón Mombiela (R)

Department of Physiology, Universidad de Valencia/INCLIVA, Avenida Blasco Ibañez 15, 46010, Valencia, Spain.
Radiologisk Afdeling, Herlev og Gentofte Hospital, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark.

Benedikt Neubauer (B)

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

Marina Obradov (M)

Sint Maartenskliniek, Nijmegen, The Netherlands.

Cyprian Olchowy (C)

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

Davide Orlandi (D)

Department of Radiology, Ospedale Evangelico Internazionale Genova, Genova, Italy.

Athena Plagou (A)

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

Raquel Prada Gonzalez (R)

Department of Radiology, Hospital POVISA, Vigo, Spain.

Saulius Rutkauskas (S)

Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania.

Ziga Snoj (Z)

University Medical Centre Ljubljana, Zaloška ul. 7, 1000, Ljubljana, Slovenia.

Alberto Stefano Tagliafico (AS)

DISSAL Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genova, Italy.
Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genova, Italy.

Alexander Talaska (A)

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

Violeta Vasilevska-Nikodinovska (V)

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

Jelena Vucetic (J)

Department of Radiology, General University Hospital of Valencia, Valencia, Spain.
Radiologisk Afdeling, Herlev og Gentofte Hospital, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark.

David Wilson (D)

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

Federico Zaottini (F)

DISSAL Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genova, Italy.

Marcello Zappia (M)

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

Georgina Allen (G)

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

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Classifications MeSH

questionsmedicales.fr › Maladies ostéomusculaires › Ténosynovite sténosante › Ténosynovite sténosante de De Quervain › Clinical indications for image-guided...
questionsmedicales.fr › Sciences de l'information › Analyse des systèmes › Méthode Delphi › Clinical indications for image-guided...
questionsmedicales.fr › Thérapeutique › Puncture sèche › Clinical indications for image-guided...
questionsmedicales.fr › Appareil locomoteur › Squelette › Articulations › Articulation du coude › Clinical indications for image-guided...
questionsmedicales.fr › Plaies et blessures › Traumatismes des tendons › Tendinopathie › Tendinopathie du coude › Clinical indications for image-guided...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Radiographie › Radioscopie › Clinical indications for image-guided...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Hormones, substituts d'hormones et antagonistes d'hormones › Hormones › Glucocorticoïdes › Clinical indications for image-guided...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Clinical indications for image-guided...
questionsmedicales.fr › Glucides › Polyosides › Glycosaminoglycanes › Acide hyaluronique › Clinical indications for image-guided...
questionsmedicales.fr › Thérapeutique › Traitement médicamenteux › Voies d'administration de substances chimiques et des médicaments › Injections › Clinical indications for image-guided...
questionsmedicales.fr › Thérapeutique › Traitement médicamenteux › Voies d'administration de substances chimiques et des médicaments › Injections › Injections articulaires › Clinical indications for image-guided...
questionsmedicales.fr › Systèmes sanguin et immunitaire › Sang › Plasma sanguin › Plasma riche en plaquettes › Clinical indications for image-guided...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Clinical indications for image-guided...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Radiographie › Clinical indications for image-guided...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Radiographie interventionnelle › Clinical indications for image-guided...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures orthopédiques › Ténotomie › Clinical indications for image-guided...
questionsmedicales.fr › Maladies ostéomusculaires › Ténosynovite sténosante › Doigt à ressaut › Clinical indications for image-guided...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Échographie interventionnelle › Clinical indications for image-guided...
questionsmedicales.fr › Actions chimiques et utilisations › Utilisations spécialisées de produits chimiques › Substances viscoélastiques › Viscosuppléments › Clinical indications for image-guided...
questionsmedicales.fr › Appareil locomoteur › Squelette › Articulations › Articulations de la main › Articulation du poignet › Clinical indications for image-guided...