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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

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    Research output: Contribution to journalJournal articleResearchpeer-review

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  • Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR)
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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%).

Original languageEnglish
JournalEuropean Radiology
Volume30
Issue number4
Pages (from-to)2220-2230
Number of pages11
ISSN0938-7994
DOIs
Publication statusPublished - Apr 2020

    Research areas

  • 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

ID: 62388325