Luca Maria Sconfienza1,2, Miraude Adriaensen3, Domenico Albano4,5, Maria Pilar Aparisi Gómez6,7, Alberto Bazzocchi8, Ian Beggs9, Bianca Bignotti10, Vito Chianca4, Angelo Corazza4,11, Danoob Dalili12,13, Miriam De Dea14, Jose Luis Del Cura15,16, Francesco Di Pietto17, Eleni Drakonaki18,19, Fernando Facal de Castro20,21, Dimitrios Filippiadis22, Jan Gielen23,24, Salvatore Gitto25, Harun Gupta26, Andrea S Klauser27, Radhesh Lalam28, Silvia Martin29,30, Carlo Martinoli31,10, Giovanni Mauri32, Catherine McCarthy13,33, Eugene McNally33, Kalliopi Melaki34, Carmelo Messina4,35, Rebeca Mirón Mombiela36,37, Benedikt Neubauer38,39, Marina Obradov40, Cyprian Olchowy41, Davide Orlandi42, Athena Plagou43, Raquel Prada Gonzalez44, Saulius Rutkauskas45, Ziga Snoj46, Alberto Stefano Tagliafico31,10, Alexander Talaska47, Violeta Vasilevska-Nikodinovska48, Jelena Vucetic21,37, David Wilson49,50, Federico Zaottini31, Marcello Zappia51,52, Georgina Allen49,50. 1. IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy. io@lucasconfienza.it. 2. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20100, 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, Via Riccardo Galeazzi 4, 20161, Milan, Italy. 5. Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy. 6. Department of Radiology, Auckland City Hospital, Auckland, 1023, New Zealand. 7. Department of Radiology, Hospital Vithas Nueve de Octubre, 46015, Valencia, Spain. 8. Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy. 9. Department of Radiology, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK. 10. Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genova, Italy. 11. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy. 12. The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 13. The Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK. 14. UOC Radiologia, Ospedale di Feltre, AULSS1 Dolomiti, Veneto, Italy. 15. Department of Radiology, Donostia University Hospital, Begiristain Doktorea Pasealekua, 109, 20014, Donostia/San Sebastian, Spain. 16. University of the Basque Country (UPV/EHU), Leioa, Spain. 17. Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, CE, Italy. 18. Private Institution of Ultrasonography and MSK Radiology, Heraklion, Greece. 19. Department of Anatomy, Medical School of the European University of Cyprus, Nicosia, Cyprus. 20. IBERORAD 1895 S.L., 08021, Barcelona, Spain. 21. Department of Radiology, General University Hospital of Valencia, Valencia, Spain. 22. 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece. 23. University of Antwerp, Antwerp, Belgium. 24. 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. Medicine, Universidad de las Islas Baleares, Palma de Mallorca, Spain. 31. DISSAL Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genova, 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, 20100, Milan, Italy. 36. Department of Physiology, Universidad de Valencia/INCLIVA, Avenida Blasco Ibañez 15, 46010, Valencia, Spain. 37. Radiologisk Afdeling, Herlev og Gentofte Hospital, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark. 38. Radiology, Medical University of Vienna, Vienna, Austria. 39. Ordensklinkum Linz, Linz, Austria. 40. Sint Maartenskliniek, Nijmegen, The Netherlands. 41. Department of Oral Surgery, Wroclaw Medical University, Wroclaw, Poland. 42. Department of Radiology, Ospedale Evangelico Internazionale Genova, Genova, Italy. 43. Department of Radiology, Private Institution of Ultrasonography, Athens, Greece. 44. Department of Radiology, Hospital POVISA, Vigo, Spain. 45. Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania. 46. University Medical Centre Ljubljana, Zaloška ul. 7, 1000, Ljubljana, Slovenia. 47. Department of Radiology, AUVA Trauma Centre, Vienna, Austria. 48. Medical Faculty, University "Ss.Cyril and Methodius", University Surgical Clinic "St.Naum Ohridski", Skopje, North Macedonia. 49. St Luke's Radiology Oxford Ltd, Oxford, UK. 50. Oxford University, Oxford, UK. 51. Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy. 52. Varelli Institute, Naples, Italy.
Abstract
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%).
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%).
Authors: Jose Manuel Rojo-Manaute; Alberto Capa-Grasa; Miguel Del Cerro-Gutiérrez; Manuel Villanueva Martínez; Francisco Chana-Rodríguez; Javier Vaquero Martín Journal: J Ultrasound Med Date: 2012-03 Impact factor: 2.153
Authors: Wilmer L Sibbitt; Philip A Band; Natalia R Chavez-Chiang; Suzanne L Delea; Hillary E Norton; Arthur D Bankhurst Journal: J Rheumatol Date: 2010-11-15 Impact factor: 4.666
Authors: Giovanni Merolla; Fabio Dellabiancia; Annamaria Ricci; Maria Pia Mussoni; Simonetta Nucci; Gustavo Zanoli; Paolo Paladini; Giuseppe Porcellini Journal: Arthroscopy Date: 2017-04-19 Impact factor: 4.772
Authors: Philipp Bosch; Francesco Carubbi; Carlo Alberto Scirè; Xenofon Baraliakos; Louise Falzon; Christian Dejaco; Pedro M Machado Journal: RMD Open Date: 2021-11