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.

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 / L.M. Sconfienza, M. Adriaensen, D. Albano, A. Alcala-Galiano, G. Allen, M.P. Aparisi Gómez, G. Aringhieri, A. Bazzocchi, I. Beggs, V. Chianca, A. Corazza, D. Dalili, M. De Dea, J.L. del Cura, F. Di Pietto, E. Drakonaki, F. Facal de Castro, D. Filippiadis, S. Gitto, A.J. Grainger, S. Greenwood, H. Gupta, S. Ivanoski, M. Khanna, A. Klauser, R. Mansour, S. Martin, V. Mascarenhas, G. Mauri, C. McCarthy, D. McKean, E. McNally, K. Melaki, C. Messina, R. Miron Mombiela, R. Moutinho, C. Olchowy, D. Orlandi, R. Prada González, M. Prakash, M. Posadzy, S. Rutkauskas, Ž. Snoj, A.S. Tagliafico, A. Talaska, X. Tomas, V. Vasilevska Nikodinovska, J. Vucetic, D. Wilson, F. Zaottini, M. Zappia, A. Isaac. - In: EUROPEAN RADIOLOGY. - ISSN 0938-7994. - (2021), pp. 1-9. [Epub ahead of print] [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

L.M. Sconfienza
Primo
;
D. Albano;S. Gitto;G. Mauri;C. Messina;
2021

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.
Interventional radiology; Ultrasonography; Nerves; Lidocaine; Corticosteroid;
Settore MED/36 - Diagnostica per Immagini e Radioterapia
2021
28-set-2021
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/870498
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