{Reference Type}: Consensus Development Conference
{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 II, elbow and wrist.
{Author}: Sconfienza LM;Adriaensen M;Albano D;Aparisi Gómez MP;Bazzocchi A;Beggs I;Bignotti B;Chianca V;Corazza A;Dalili D;De Dea M;Del Cura JL;Di Pietto F;Drakonaki E;Facal de Castro F;Filippiadis D;Gielen J;Gitto S;Gupta H;Klauser AS;Lalam R;Martin S;Martinoli C;Mauri G;McCarthy C;McNally E;Melaki K;Messina C;Mirón Mombiela R;Neubauer B;Obradov M;Olchowy C;Orlandi D;Plagou A;Prada Gonzalez R;Rutkauskas S;Snoj Z;Tagliafico AS;Talaska A;Vasilevska-Nikodinovska V;Vucetic J;Wilson D;Zaottini F;Zappia M;Allen G; ;
{Journal}: Eur Radiol
{Volume}: 30
{Issue}: 4
{Year}: Apr 2020
{Factor}: 7.034
{DOI}: 10.1007/s00330-019-06545-6
{Abstract}: <B>BACKGROUND: </B>Although image-guided interventional procedures of the elbow and wrist are routinely performed, there is poor evidence in the literature concerning such treatments. Our aim was to perform a Delphi-based consensus on published evidence on image-guided interventional procedures around the elbow and wrist and provide clinical indications on this topic.<BR><B>METHODS: </B>A board of 45 experts in image-guided interventional musculoskeletal procedures from the European Society of Musculoskeletal Radiology were involved in this Delphi-based consensus study. All panelists reviewed and scored published papers on image-guided interventional procedures around the elbow and wrist updated to September 2018 according to the Oxford Centre for Evidence-based Medicine levels of evidence. Consensus on statements drafted by the panelists about clinical indications was considered as "strong" when more than 95% of panelists agreed and as "broad" if more than 80% agreed.<BR><B>RESULTS: </B>Eighteen statements were drafted, 12 about tendon procedures and 6 about intra-articular procedures. Only statement #15 reached the highest level of evidence (ultrasound-guided steroid wrist injections result in greater pain reduction and greater likelihood of attaining clinically important improvement). Seventeen statements received strong consensus (94%), while one received broad consensus (6%).<BR><B>CONCLUSIONS: </B>There is still poor evidence in published papers on image-guided interventional procedures around the elbow and wrist. A strong consensus has been achieved in 17/18 (94%) statements provided by the panel on clinical indications. Large prospective randomized trials are needed to better define the role of these procedures in clinical practice.<BR><B>CONCLUSIONS: </B>• The panel provided 18 evidence-based statements on clinical indications of image-guided interventional procedures around the elbow and wrist. • Only statement #15 reached the highest level of evidence: ultrasound-guided steroid wrist injections result in greater pain reduction and greater likelihood of attaining clinically important improvement. • Seventeen statements received strong consensus (94%), while broad consensus was obtained by 1 statement (6%).