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 I, shoulder

Luca Maria Sconfienza, Miraude Adriaensen, Domenico Albano, Georgina Allen, Maria Pilar Aparisi Gómez, Alberto Bazzocchi, Ian Beggs, Bianca Bignotti, Vito Chianca, Angelo Corazza, Danoob Dalili, Miriam De Dea, Jose Luis Del Cura, Francesco Di Pietto, Eleni Drakonaki, Fernando Facal de Castro, Dimitrios Filippiadis, Jan Gielen, Salvatore Gitto, Harun GuptaAndrea S Klauser, Radhesh Lalam, Silvia Martin, Carlo Martinoli, Giovanni Mauri, Catherine McCarthy, Eugene McNally, Kalliopi Melaki, Carmelo Messina, Rebeca Mirón Mombiela, Benedikt Neubauer, Cyprian Olchowy, Davide Orlandi, Athena Plagou, Raquel Prada Gonzalez, Saulius Rutkauskas, Ziga Snoj, Alberto Stefano Tagliafico, Alexander Talaska, Violeta Vasilevska-Nikodinovska, Jelena Vucetic, David Wilson, Federico Zaottini, Marcello Zappia, Marina Obradov

Research output: Contribution to journalArticlepeer-review

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%).

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalEuropean Radiology
DOIs
Publication statusE-pub ahead of print - Sep 16 2019

Keywords

  • Injections
  • Interventional radiology
  • Platelet-rich plasma
  • Shoulder
  • Ultrasonography

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