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 III, nerves of the upper limb

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

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Image-guided interventional procedures of the nerves are commonly performed by physicians from different medical specialties, although there is a lack of clinical indications for these types of procedures. This Delphi-based consensus provided a list of indications on image-guided interventional procedures for nerves of the upper limb based on updated published evidence.

METHODS: An expert panel of 45 members of the Ultrasound and Interventional Subcommittees of the ESSR participated in this Delphi-based consensus study. After revision of the published papers on image-guided interventional procedures for nerves of the upper limb updated to September 2018, the experts drafted a list of statements according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus on statements regarding clinical indications was considered as strong when more than 95% of experts agreed, and broad if more than 80% agreed.

RESULTS: Ten statements were drafted on procedures for nerves of the upper limb. Only two statements reached the highest level of evidence (ultrasound guidance is a safe and effective method for brachial plexus block; ultrasound-guided non-surgical approaches are safe and effective methods to treat carpal tunnel syndrome in the short term, but there is sparse evidence on the mid- and long-term effectiveness of these interventions). Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%).

CONCLUSIONS: This Delphi-based consensus study reported poor evidence on image-guided interventional procedures for nerves of the upper limb. Sixty percent of statements on clinical indications provided by the expert board reached a strong consensus.

KEY POINTS: • An expert panel of the ESSR provided 10 evidence-based statements on clinical indications for image-guided interventional procedures for nerves of the upper limb • Two statements reached the highest level of evidence • Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%).

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalEuropean Radiology
DOIs
Publication statusE-pub ahead of print - Nov 11 2019

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Oculomotor Nerve
Musculoskeletal System
Upper Extremity
Radiology
Interventional Ultrasonography
Carpal Tunnel Syndrome
Evidence-Based Medicine
Medicine
Physicians

Keywords

  • Injections
  • Steroids
  • Peripheral nerves
  • Radiology
  • interventional
  • Ultrasonography

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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 III, nerves of the upper limb. / Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR).

In: European Radiology, 11.11.2019, p. 1-9.

Research output: Contribution to journalArticle

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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 III, nerves of the upper limb",
abstract = "BACKGROUND: Image-guided interventional procedures of the nerves are commonly performed by physicians from different medical specialties, although there is a lack of clinical indications for these types of procedures. This Delphi-based consensus provided a list of indications on image-guided interventional procedures for nerves of the upper limb based on updated published evidence.METHODS: An expert panel of 45 members of the Ultrasound and Interventional Subcommittees of the ESSR participated in this Delphi-based consensus study. After revision of the published papers on image-guided interventional procedures for nerves of the upper limb updated to September 2018, the experts drafted a list of statements according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus on statements regarding clinical indications was considered as strong when more than 95{\%} of experts agreed, and broad if more than 80{\%} agreed.RESULTS: Ten statements were drafted on procedures for nerves of the upper limb. Only two statements reached the highest level of evidence (ultrasound guidance is a safe and effective method for brachial plexus block; ultrasound-guided non-surgical approaches are safe and effective methods to treat carpal tunnel syndrome in the short term, but there is sparse evidence on the mid- and long-term effectiveness of these interventions). Strong consensus was obtained on 6/10 statements (60{\%}), while 4/10 statements reached broad consensus (40{\%}).CONCLUSIONS: This Delphi-based consensus study reported poor evidence on image-guided interventional procedures for nerves of the upper limb. Sixty percent of statements on clinical indications provided by the expert board reached a strong consensus.KEY POINTS: • An expert panel of the ESSR provided 10 evidence-based statements on clinical indications for image-guided interventional procedures for nerves of the upper limb • Two statements reached the highest level of evidence • Strong consensus was obtained on 6/10 statements (60{\%}), while 4/10 statements reached broad consensus (40{\%}).",
keywords = "Injections, Steroids, Peripheral nerves, Radiology, interventional, Ultrasonography",
author = "{Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR)} and Sconfienza, {Luca Maria} and Miraude Adriaensen and Domenico Albano and Georgina Allen and {Aparisi G{\'o}mez}, {Maria Pilar} and Alberto Bazzocchi and Ian Beggs and Bianca Bignotti and Vito Chianca and Angelo Corazza and Danoob Dalili and {De Dea}, Miriam and {Del Cura}, {Jose Luis} and {Di Pietto}, Francesco and Eleni Drakonaki and {Facal de Castro}, Fernando and Dimitrios Filippiadis and Jan Gielen and Salvatore Gitto and Harun Gupta and Klauser, {Andrea S} and Radhesh Lalam and Silvia Martin and Carlo Martinoli and Giovanni Mauri and Catherine McCarthy and Eugene McNally and Kalliopi Melaki and Carmelo Messina and {Mir{\'o}n Mombiela}, Rebeca and Benedikt Neubauer and Marina Obradov and Cyprian Olchowy and Davide Orlandi and Gonzalez, {Raquel Prada} and Saulius Rutkauskas and Ziga Snoj and Tagliafico, {Alberto Stefano} and Alexander Talaska and Violeta Vasilevska-Nikodinovska and Jelena Vucetic and David Wilson and Federico Zaottini and Marcello Zappia and Athena Plagou",
year = "2019",
month = "11",
day = "11",
doi = "10.1007/s00330-019-06479-z",
language = "English",
pages = "1--9",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",

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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 III, nerves of the upper limb

AU - Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR)

AU - Sconfienza, Luca Maria

AU - Adriaensen, Miraude

AU - Albano, Domenico

AU - Allen, Georgina

AU - Aparisi Gómez, Maria Pilar

AU - Bazzocchi, Alberto

AU - Beggs, Ian

AU - Bignotti, Bianca

AU - Chianca, Vito

AU - Corazza, Angelo

AU - Dalili, Danoob

AU - De Dea, Miriam

AU - Del Cura, Jose Luis

AU - Di Pietto, Francesco

AU - Drakonaki, Eleni

AU - Facal de Castro, Fernando

AU - Filippiadis, Dimitrios

AU - Gielen, Jan

AU - Gitto, Salvatore

AU - Gupta, Harun

AU - Klauser, Andrea S

AU - Lalam, Radhesh

AU - Martin, Silvia

AU - Martinoli, Carlo

AU - Mauri, Giovanni

AU - McCarthy, Catherine

AU - McNally, Eugene

AU - Melaki, Kalliopi

AU - Messina, Carmelo

AU - Mirón Mombiela, Rebeca

AU - Neubauer, Benedikt

AU - Obradov, Marina

AU - Olchowy, Cyprian

AU - Orlandi, Davide

AU - Gonzalez, Raquel Prada

AU - Rutkauskas, Saulius

AU - Snoj, Ziga

AU - Tagliafico, Alberto Stefano

AU - Talaska, Alexander

AU - Vasilevska-Nikodinovska, Violeta

AU - Vucetic, Jelena

AU - Wilson, David

AU - Zaottini, Federico

AU - Zappia, Marcello

AU - Plagou, Athena

PY - 2019/11/11

Y1 - 2019/11/11

N2 - BACKGROUND: Image-guided interventional procedures of the nerves are commonly performed by physicians from different medical specialties, although there is a lack of clinical indications for these types of procedures. This Delphi-based consensus provided a list of indications on image-guided interventional procedures for nerves of the upper limb based on updated published evidence.METHODS: An expert panel of 45 members of the Ultrasound and Interventional Subcommittees of the ESSR participated in this Delphi-based consensus study. After revision of the published papers on image-guided interventional procedures for nerves of the upper limb updated to September 2018, the experts drafted a list of statements according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus on statements regarding clinical indications was considered as strong when more than 95% of experts agreed, and broad if more than 80% agreed.RESULTS: Ten statements were drafted on procedures for nerves of the upper limb. Only two statements reached the highest level of evidence (ultrasound guidance is a safe and effective method for brachial plexus block; ultrasound-guided non-surgical approaches are safe and effective methods to treat carpal tunnel syndrome in the short term, but there is sparse evidence on the mid- and long-term effectiveness of these interventions). Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%).CONCLUSIONS: This Delphi-based consensus study reported poor evidence on image-guided interventional procedures for nerves of the upper limb. Sixty percent of statements on clinical indications provided by the expert board reached a strong consensus.KEY POINTS: • An expert panel of the ESSR provided 10 evidence-based statements on clinical indications for image-guided interventional procedures for nerves of the upper limb • Two statements reached the highest level of evidence • Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%).

AB - BACKGROUND: Image-guided interventional procedures of the nerves are commonly performed by physicians from different medical specialties, although there is a lack of clinical indications for these types of procedures. This Delphi-based consensus provided a list of indications on image-guided interventional procedures for nerves of the upper limb based on updated published evidence.METHODS: An expert panel of 45 members of the Ultrasound and Interventional Subcommittees of the ESSR participated in this Delphi-based consensus study. After revision of the published papers on image-guided interventional procedures for nerves of the upper limb updated to September 2018, the experts drafted a list of statements according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus on statements regarding clinical indications was considered as strong when more than 95% of experts agreed, and broad if more than 80% agreed.RESULTS: Ten statements were drafted on procedures for nerves of the upper limb. Only two statements reached the highest level of evidence (ultrasound guidance is a safe and effective method for brachial plexus block; ultrasound-guided non-surgical approaches are safe and effective methods to treat carpal tunnel syndrome in the short term, but there is sparse evidence on the mid- and long-term effectiveness of these interventions). Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%).CONCLUSIONS: This Delphi-based consensus study reported poor evidence on image-guided interventional procedures for nerves of the upper limb. Sixty percent of statements on clinical indications provided by the expert board reached a strong consensus.KEY POINTS: • An expert panel of the ESSR provided 10 evidence-based statements on clinical indications for image-guided interventional procedures for nerves of the upper limb • Two statements reached the highest level of evidence • Strong consensus was obtained on 6/10 statements (60%), while 4/10 statements reached broad consensus (40%).

KW - Injections

KW - Steroids

KW - Peripheral nerves

KW - Radiology

KW - interventional

KW - Ultrasonography

U2 - 10.1007/s00330-019-06479-z

DO - 10.1007/s00330-019-06479-z

M3 - Article

C2 - 31712960

SP - 1

EP - 9

JO - European Radiology

JF - European Radiology

SN - 0938-7994

ER -