Luca Maria Sconfienza1,2, Miraude Adriaensen3, Domenico Albano4,5, Georgina Allen6,7, Maria Pilar Aparisi Gómez8,9, Alberto Bazzocchi10, Ian Beggs11, Bianca Bignotti12, Vito Chianca4, Angelo Corazza4,13, Danoob Dalili14,15, Miriam De Dea16, Jose Luis Del Cura17,18, Francesco Di Pietto19, Eleni Drakonaki20, Fernando Facal de Castro21,22, Dimitrios Filippiadis23, Jan Gielen24, Salvatore Gitto25, Harun Gupta26, Andrea S Klauser27, Radhesh Lalam28, Silvia Martin29,30, Carlo Martinoli31, Giovanni Mauri32, Catherine McCarthy15,33, Eugene McNally33, Kalliopi Melaki34, Carmelo Messina4,35, Rebeca Mirón Mombiela36,37, Benedikt Neubauer38, Cyprian Olchowy39, Davide Orlandi40, Athena Plagou41, Raquel Prada Gonzalez42, Saulius Rutkauskas43, Ziga Snoj44, Alberto Stefano Tagliafico12,45, Alexander Talaska46, Violeta Vasilevska-Nikodinovska47, Jelena Vucetic22,37, David Wilson6,7, Federico Zaottini48, Marcello Zappia49,50, Marina Obradov51. 1. IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy. io@lucasconfienza.it. 2. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy. io@lucasconfienza.it. 3. Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, the Netherlands. 4. IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy. 5. Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy. 6. St Luke's Radiology Oxford Ltd, Oxford, UK. 7. University of Oxford, Oxford, UK. 8. Department of Radiology, Auckland City Hospital, Auckland, 1023, New Zealand. 9. Department of Radiology, Hospital Vithas Nueve de Octubre, 46015, Valencia, Spain. 10. Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy. 11. Department of Radiology, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK. 12. Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy. 13. Department of Neurosciences, University of Genova, Genoa, Italy. 14. The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 15. Nuffield Orthopaedic Hospital, Oxford, UK. 16. UOC Radiologia, Ospedale di Feltre, AULSS 1 Dolomiti, Veneto, Italy. 17. Department of Radiology, Donostia University Hospital, Begiristain Doktorea Pasealekua, 109, 20014, Donostia/San Sebastian, Spain. 18. University of the Basque Country (UPV/EHU), Leioa, Spain. 19. Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, CE, Italy. 20. Department of Musculoskeletal Radiology, Private Ultrasound Institution, Heraklion, Greece. 21. IBERORAD 1895 S.L., 08021, Barcelona, Spain. 22. Department of Radiology, General University Hospital of Valencia, Valencia, Spain. 23. 2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Athens, Greece. 24. University of Antwerp, University of Antwerp Hospital (UZA), Antwerp, Belgium. 25. Università degli Studi di Milano, Milan, Italy. 26. Leeds Teaching Hospitals, Leeds, UK. 27. Department of Radiology, Medical University Innsbruck, Innsbruck, Austria. 28. The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, UK. 29. Hospital Son Llatzer, Palma de Mallorca, Spain. 30. Universidad de las Islas Baleares, Palma, Spain. 31. DISSAL Department of Health Sciences, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy. 32. Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy. 33. Oxford Musculoskeletal Radiology, Oxford, UK. 34. Medical School of the National and Kapodistrian University of Athens, Athens, Greece. 35. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy. 36. Department of Physiology, Universidad de Valencia/INCLIVA, Avenida Blasco Ibañez 15, 46010, Valencia, Spain. 37. Herlev og Gentofte Hospital Radiologisk Afdeling, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark. 38. Radiology, Ordensklinikum, Seilerstätte 4, 4020, Linz, Austria. 39. Department of Oral Dentistry, Wroclaw Medical University, Wroclaw, Poland. 40. Ospedale Evangelico Internazionale Genova, Genoa, Italy. 41. Department of Radiology, Private Institution of Ultrasonography, Athens, Greece. 42. POVISA Hospital, Vigo, Pontevedra, Spain. 43. Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania. 44. Institute of Radiology, University Medical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia. 45. Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy. 46. Department of Radiology, AUVA Trauma Centre, Vienna, Austria. 47. Medical Faculty, University "Ss.Cyril and Methodius", Skopje, North Macedonia; University Surgical Clinic "St.Naum Ohridski", Skopje, North Macedonia. 48. Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy. 49. Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy. 50. Varelli Institute, Naples, Italy. 51. Sint Maartenskliniek, 6500GM, 9011, Nijmegen, the Netherlands.
Abstract
BACKGROUND: Image-guided interventional procedures around the shoulder are commonly performed in clinical practice, although evidence regarding their effectiveness is scarce. We report the results of a Delphi method review of evidence on literature published on image-guided interventional procedures around the shoulder with a list of clinical indications. METHODS: Forty-five experts in image-guided musculoskeletal procedures from the ESSR participated in a consensus study using the Delphic method. Peer-reviewed papers regarding interventional procedures around the shoulder up to September 2018 were scored according to the Oxford Centre for Evidence-based Medicine levels of evidence. Statements on clinical indications were constructed. Consensus was considered as strong if more than 95% of experts agreed and as broad if more than 80% agreed. RESULTS: A total of 20 statements were drafted, and 5 reached the highest level of evidence. There were 10 statements about tendon procedures, 6 about intra-articular procedures, and 4 about intrabursal injections. Strong consensus was obtained in 16 of them (80%), while 4 received broad consensus (20%). CONCLUSIONS: Literature evidence on image-guided interventional procedures around the shoulder is limited. A strong consensus has been reached for 80% of statements. The ESSR recommends further research to potentially influence treatment options, patient outcomes, and social impact. KEY POINTS: • Expert consensus produced a list of 20 evidence-based statements on clinical indications of image-guided interventional procedures around the shoulder. • The highest level of evidence was reached for five statements. • Strong consensus was obtained for 16 statements (80%), while 4 received broad consensus (20%).
BACKGROUND: Image-guided interventional procedures around the shoulder are commonly performed in clinical practice, although evidence regarding their effectiveness is scarce. We report the results of a Delphi method review of evidence on literature published on image-guided interventional procedures around the shoulder with a list of clinical indications. METHODS: Forty-five experts in image-guided musculoskeletal procedures from the ESSR participated in a consensus study using the Delphic method. Peer-reviewed papers regarding interventional procedures around the shoulder up to September 2018 were scored according to the Oxford Centre for Evidence-based Medicine levels of evidence. Statements on clinical indications were constructed. Consensus was considered as strong if more than 95% of experts agreed and as broad if more than 80% agreed. RESULTS: A total of 20 statements were drafted, and 5 reached the highest level of evidence. There were 10 statements about tendon procedures, 6 about intra-articular procedures, and 4 about intrabursal injections. Strong consensus was obtained in 16 of them (80%), while 4 received broad consensus (20%). CONCLUSIONS: Literature evidence on image-guided interventional procedures around the shoulder is limited. A strong consensus has been reached for 80% of statements. The ESSR recommends further research to potentially influence treatment options, patient outcomes, and social impact. KEY POINTS: • Expert consensus produced a list of 20 evidence-based statements on clinical indications of image-guided interventional procedures around the shoulder. • The highest level of evidence was reached for five statements. • Strong consensus was obtained for 16 statements (80%), while 4 received broad consensus (20%).
Authors: Timothy S Johnson; Addisu Mesfin; Kevin W Farmer; Lawrence A McGuigan; Ines G Alamo; Lynne C Jones; David C Johnson Journal: Arthroscopy Date: 2011-06 Impact factor: 4.772
Authors: Pieter Bas de Witte; Jasmijn W Selten; Ana Navas; Jochem Nagels; Cornelis P J Visser; Rob G H H Nelissen; Monique Reijnierse Journal: Am J Sports Med Date: 2013-05-21 Impact factor: 6.202
Authors: Ashish Patel; Nicholson Chadwick; Kelly von Beck; Pulak Goswami; Steven B Soliman; Arjun Patel; Kevin C McGill Journal: Skeletal Radiol Date: 2022-08-31 Impact factor: 2.128