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 VII, nerves of the lower limb

Luca Maria Sconfienza; Miraude Adriaensen; Domenico Albano; Andrea Alcala-Galiano; Georgina Allen; Maria Pilar Aparisi Gómez; Giacomo Aringhieri; Alberto Bazzocchi; Ian Beggs; Vito Chianca; Angelo Corazza; Danoob Dalili; Miriam De Dea; Jose Luis Del Cura; Francesco Di Pietto; Elena Drakonaki; Fernando Facal de Castro; Dimitrios Filippiadis; Salvatore Gitto; Andrew J Grainger; Simon Greenwood; Harun Gupta; Slavcho Ivanoski; Monica Khanna; Andrea Klauser; Ramy Mansour; Silvia Martin; Vasco Mascarenhas; Giovanni Mauri; Catherine McCarthy; David McKean; Eugene McNally; Kalliopi Melaki; Carmelo Messina; Rebeca Miron Mombiela; Ricardo Moutinho; Cyprian Olchowy; Davide Orlandi; Raquel Prada González; Mahesh Prakash; Magdalena Posadzy; Saulius Rutkauskas; Žiga Snoj; Alberto Stefano Tagliafico; Alexander Talaska; Xavier Tomas; Violeta Vasilevska Nikodinovska; Jelena Vucetic; David Wilson; Federico Zaottini; Marcello Zappia; Amanda Isaac

doi:10.1007/s00330-021-08283-0

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 VII, nerves of the lower limb

Luca Maria Sconfienza, Miraude Adriaensen, Domenico Albano, Andrea Alcala-Galiano, Georgina Allen, Maria Pilar Aparisi Gómez, Giacomo Aringhieri, Alberto Bazzocchi, Ian Beggs, Vito Chianca, Angelo Corazza, Danoob Dalili, Miriam De Dea, Jose Luis Del Cura, Francesco Di Pietto, Elena Drakonaki, Fernando Facal de Castro, Dimitrios Filippiadis, Salvatore Gitto, Andrew J GraingerSimon Greenwood, Harun Gupta, Slavcho Ivanoski, Monica Khanna, Andrea Klauser, Ramy Mansour, Silvia Martin, Vasco Mascarenhas, Giovanni Mauri, Catherine McCarthy, David McKean, Eugene McNally, Kalliopi Melaki, Carmelo Messina, Rebeca Miron Mombiela, Ricardo Moutinho, Cyprian Olchowy, Davide Orlandi, Raquel Prada González, Mahesh Prakash, Magdalena Posadzy, Saulius Rutkauskas, Žiga Snoj, Alberto Stefano Tagliafico, Alexander Talaska, Xavier Tomas, Violeta Vasilevska Nikodinovska, Jelena Vucetic, David Wilson, Federico Zaottini, Marcello Zappia, Amanda Isaac

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: To perform a Delphi-based consensus on published evidence on image-guided interventional procedures for peripheral nerves of the lower limb (excluding Morton's neuroma) and provide clinical indications.

METHODS: We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around peripheral nerves in the lower limb (excluding Morton's neuroma) to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper.

RESULTS: Nine statements on image-guided interventional procedures for peripheral nerves of the lower limb have been drafted. All of them received strong consensus. Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia.

CONCLUSION: Despite the promising results reported by published papers on image-guided interventional procedures for peripheral nerves of the lower limb, there is still a lack of evidence on the efficacy of most procedures.

KEY POINTS: • Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. • US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. • US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia. The volume of local anesthetic affects the size of the blocked sensory area.

Original language	English
Pages (from-to)	1456-1464
Number of pages	9
Journal	European Radiology
Volume	32
Issue number	3
DOIs	https://doi.org/10.1007/s00330-021-08283-0
Publication status	Published - Mar 2022

Keywords

Corticosteroid
Interventional radiology
Lidocaine
Nerves
Ultrasonography

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10.1007/s00330-021-08283-0

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Sconfienza, L. M., Adriaensen, M., Albano, D., Alcala-Galiano, A., Allen, G., Aparisi Gómez, M. P., Aringhieri, G., Bazzocchi, A., Beggs, I., Chianca, V., Corazza, A., Dalili, D., De Dea, M., Del Cura, J. L., Di Pietto, F., Drakonaki, E., Facal de Castro, F., Filippiadis, D., Gitto, S., ... Isaac, A. (2022). 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 VII, nerves of the lower limb. European Radiology, 32(3), 1456-1464. https://doi.org/10.1007/s00330-021-08283-0

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 VII, nerves of the lower limb. / Sconfienza, Luca Maria; Adriaensen, Miraude; Albano, Domenico et al.

In: European Radiology, Vol. 32, No. 3, 03.2022, p. 1456-1464.

Research output: Contribution to journal › Article › peer-review

Sconfienza, LM, Adriaensen, M, Albano, D, Alcala-Galiano, A, Allen, G, Aparisi Gómez, MP, Aringhieri, G, Bazzocchi, A, Beggs, I, Chianca, V, Corazza, A, Dalili, D, De Dea, M, Del Cura, JL, Di Pietto, F, Drakonaki, E, Facal de Castro, F, Filippiadis, D, Gitto, S, Grainger, AJ, Greenwood, S, Gupta, H, Ivanoski, S, Khanna, M, Klauser, A, Mansour, R, Martin, S, Mascarenhas, V, Mauri, G, McCarthy, C, McKean, D, McNally, E, Melaki, K, Messina, C, Miron Mombiela, R, Moutinho, R, Olchowy, C, Orlandi, D, Prada González, R, Prakash, M, Posadzy, M, Rutkauskas, S, Snoj, Ž, Tagliafico, AS, Talaska, A, Tomas, X, Vasilevska Nikodinovska, V, Vucetic, J, Wilson, D, Zaottini, F, Zappia, M & Isaac, A 2022, '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 VII, nerves of the lower limb', European Radiology, vol. 32, no. 3, pp. 1456-1464. https://doi.org/10.1007/s00330-021-08283-0

Sconfienza LM, Adriaensen M, Albano D, Alcala-Galiano A, Allen G, Aparisi Gómez MP et al. 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 VII, nerves of the lower limb. European Radiology. 2022 Mar;32(3):1456-1464. doi: 10.1007/s00330-021-08283-0

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title = "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 VII, nerves of the lower limb",

abstract = "OBJECTIVES: To perform a Delphi-based consensus on published evidence on image-guided interventional procedures for peripheral nerves of the lower limb (excluding Morton's neuroma) and provide clinical indications.METHODS: We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around peripheral nerves in the lower limb (excluding Morton's neuroma) to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper.RESULTS: Nine statements on image-guided interventional procedures for peripheral nerves of the lower limb have been drafted. All of them received strong consensus. Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia.CONCLUSION: Despite the promising results reported by published papers on image-guided interventional procedures for peripheral nerves of the lower limb, there is still a lack of evidence on the efficacy of most procedures.KEY POINTS: • Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. • US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. • US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia. The volume of local anesthetic affects the size of the blocked sensory area.",

keywords = "Corticosteroid, Interventional radiology, Lidocaine, Nerves, Ultrasonography",

author = "Sconfienza, {Luca Maria} and Miraude Adriaensen and Domenico Albano and Andrea Alcala-Galiano and Georgina Allen and {Aparisi G{\'o}mez}, {Maria Pilar} and Giacomo Aringhieri and Alberto Bazzocchi and Ian Beggs and Vito Chianca and Angelo Corazza and Danoob Dalili and {De Dea}, Miriam and {Del Cura}, {Jose Luis} and {Di Pietto}, Francesco and Elena Drakonaki and {Facal de Castro}, Fernando and Dimitrios Filippiadis and Salvatore Gitto and Grainger, {Andrew J} and Simon Greenwood and Harun Gupta and Slavcho Ivanoski and Monica Khanna and Andrea Klauser and Ramy Mansour and Silvia Martin and Vasco Mascarenhas and Giovanni Mauri and Catherine McCarthy and David McKean and Eugene McNally and Kalliopi Melaki and Carmelo Messina and {Miron Mombiela}, Rebeca and Ricardo Moutinho and Cyprian Olchowy and Davide Orlandi and {Prada Gonz{\'a}lez}, Raquel and Mahesh Prakash and Magdalena Posadzy and Saulius Rutkauskas and {\v Z}iga Snoj and Tagliafico, {Alberto Stefano} and Alexander Talaska and Xavier Tomas and {Vasilevska Nikodinovska}, Violeta and Jelena Vucetic and David Wilson and Federico Zaottini and Marcello Zappia and Amanda Isaac",

note = "{\textcopyright} 2021. The Author(s).",

year = "2022",

month = mar,

doi = "10.1007/s00330-021-08283-0",

language = "English",

volume = "32",

pages = "1456--1464",

journal = "European Radiology",

issn = "0938-7994",

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TY - JOUR

T1 - 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 VII, nerves of the lower limb

AU - Sconfienza, Luca Maria

AU - Adriaensen, Miraude

AU - Albano, Domenico

AU - Alcala-Galiano, Andrea

AU - Allen, Georgina

AU - Aparisi Gómez, Maria Pilar

AU - Aringhieri, Giacomo

AU - Bazzocchi, Alberto

AU - Beggs, Ian

AU - Chianca, Vito

AU - Corazza, Angelo

AU - Dalili, Danoob

AU - De Dea, Miriam

AU - Del Cura, Jose Luis

AU - Di Pietto, Francesco

AU - Drakonaki, Elena

AU - Facal de Castro, Fernando

AU - Filippiadis, Dimitrios

AU - Gitto, Salvatore

AU - Grainger, Andrew J

AU - Greenwood, Simon

AU - Gupta, Harun

AU - Ivanoski, Slavcho

AU - Khanna, Monica

AU - Klauser, Andrea

AU - Mansour, Ramy

AU - Martin, Silvia

AU - Mascarenhas, Vasco

AU - Mauri, Giovanni

AU - McCarthy, Catherine

AU - McKean, David

AU - McNally, Eugene

AU - Melaki, Kalliopi

AU - Messina, Carmelo

AU - Miron Mombiela, Rebeca

AU - Moutinho, Ricardo

AU - Olchowy, Cyprian

AU - Orlandi, Davide

AU - Prada González, Raquel

AU - Prakash, Mahesh

AU - Posadzy, Magdalena

AU - Rutkauskas, Saulius

AU - Snoj, Žiga

AU - Tagliafico, Alberto Stefano

AU - Talaska, Alexander

AU - Tomas, Xavier

AU - Vasilevska Nikodinovska, Violeta

AU - Vucetic, Jelena

AU - Wilson, David

AU - Zaottini, Federico

AU - Zappia, Marcello

AU - Isaac, Amanda

PY - 2022/3

Y1 - 2022/3

N2 - OBJECTIVES: To perform a Delphi-based consensus on published evidence on image-guided interventional procedures for peripheral nerves of the lower limb (excluding Morton's neuroma) and provide clinical indications.METHODS: We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around peripheral nerves in the lower limb (excluding Morton's neuroma) to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper.RESULTS: Nine statements on image-guided interventional procedures for peripheral nerves of the lower limb have been drafted. All of them received strong consensus. Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia.CONCLUSION: Despite the promising results reported by published papers on image-guided interventional procedures for peripheral nerves of the lower limb, there is still a lack of evidence on the efficacy of most procedures.KEY POINTS: • Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. • US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. • US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia. The volume of local anesthetic affects the size of the blocked sensory area.

AB - OBJECTIVES: To perform a Delphi-based consensus on published evidence on image-guided interventional procedures for peripheral nerves of the lower limb (excluding Morton's neuroma) and provide clinical indications.METHODS: We report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology who reviewed the published literature for evidence on image-guided interventional procedures offered around peripheral nerves in the lower limb (excluding Morton's neuroma) to derive their clinical indications. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when > 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the Delphi-based consensus were used to write the paper.RESULTS: Nine statements on image-guided interventional procedures for peripheral nerves of the lower limb have been drafted. All of them received strong consensus. Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia.CONCLUSION: Despite the promising results reported by published papers on image-guided interventional procedures for peripheral nerves of the lower limb, there is still a lack of evidence on the efficacy of most procedures.KEY POINTS: • Image-guided pudendal nerve block is safe, effective, and well tolerated with few complications. • US-guided perisciatic injection of anesthetic provides good symptom relief in patients with piriformis syndrome; however, the addition of corticosteroids to local anesthetics still has an unclear role. • US-guided lateral femoral cutaneous nerve block can be used to provide effective post-operative regional analgesia. The volume of local anesthetic affects the size of the blocked sensory area.

KW - Corticosteroid

KW - Interventional radiology

KW - Lidocaine

KW - Nerves

KW - Ultrasonography

U2 - 10.1007/s00330-021-08283-0

DO - 10.1007/s00330-021-08283-0

M3 - Article

C2 - 34581843

VL - 32

SP - 1456

EP - 1464

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 3

ER -