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.

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 / L.M. Sconfienza, M. Adriaensen, D. Albano, G. Allen, M.P. Aparisi Gómez, A. Bazzocchi, I. Beggs, B. Bignotti, V. Chianca, A. Corazza, D. Dalili, M. De Dea, J.L. del Cura, F. Di Pietto, E. Drakonaki, F. Facal de Castro, D. Filippiadis, J. Gielen, S. Gitto, H. Gupta, A.S. Klauser, R. Lalam, S. Martin, C. Martinoli, G. Mauri, C. McCarthy, E. McNally, K. Melaki, C. Messina, R. Mirón Mombiela, B. Neubauer, M. Obradov, C. Olchowy, D. Orlandi, R.P. Gonzalez, S. Rutkauskas, Z. Snoj, A.S. Tagliafico, A. Talaska, V. Vasilevska-Nikodinovska, J. Vucetic, D. Wilson, F. Zaottini, M. Zappia, A. Plagou. - In: EUROPEAN RADIOLOGY. - ISSN 0938-7994. - 30:3(2020 Mar), pp. 1498-1506. [10.1007/s00330-019-06479-z]

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

L.M. Sconfienza
Primo
;
S. Gitto;G. Mauri;C. Messina;
2020-03

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.
Radiology; interventional; Ultrasonography; Peripheral nerves; Injections; Steroids
Settore MED/36 - Diagnostica per Immagini e Radioterapia
11-nov-2019
Article (author)
File in questo prodotto:
File Dimensione Formato  
Sconfienza2019_Article_ClinicalIndicationsForImageGui.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 341.3 kB
Formato Adobe PDF
341.3 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Sconfienza2020_Article_ClinicalIndicationsForImageGui.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 348.05 kB
Formato Adobe PDF
348.05 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/690105
Citazioni
  • ???jsp.display-item.citation.pmc??? 10
  • Scopus 22
  • ???jsp.display-item.citation.isi??? 21
social impact