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 I, shoulder

Luca Maria Sconfienza^{1

2}, Miraude Adriaensen³, Domenico Albano^{4

5}, Georgina Allen^{6

7}, Maria Pilar Aparisi Gómez^{8

9}, Alberto Bazzocchi¹⁰, Ian Beggs¹¹, Bianca Bignotti¹², Vito Chianca⁴, Angelo Corazza^{4

13}, Danoob Dalili^{14

15}, Miriam De Dea¹⁶, Jose Luis Del Cura^{17

18}, Francesco Di Pietto¹⁹, Eleni Drakonaki²⁰, Fernando Facal de Castro^{21

22}, Dimitrios Filippiadis²³, Jan Gielen²⁴, Salvatore Gitto²⁵, Harun Gupta²⁶, Andrea S Klauser²⁷, Radhesh Lalam²⁸, Silvia Martin^{29

30}, Carlo Martinoli³¹, Giovanni Mauri³², Catherine McCarthy^{15

33}, Eugene McNally³³, Kalliopi Melaki³⁴, Carmelo Messina^{4

35}, Rebeca Mirón Mombiela^{36

37}, Benedikt Neubauer³⁸, Cyprian Olchowy³⁹, Davide Orlandi⁴⁰, Athena Plagou⁴¹, Raquel Prada Gonzalez⁴², Saulius Rutkauskas⁴³, Ziga Snoj⁴⁴, Alberto Stefano Tagliafico^{12

45}, Alexander Talaska⁴⁶, Violeta Vasilevska-Nikodinovska⁴⁷, Jelena Vucetic^{22

37}, David Wilson^{6

7}, Federico Zaottini⁴⁸, Marcello Zappia^{49

50}, Marina Obradov⁵¹

Affiliations

¹ IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy. io@lucasconfienza.it.
² Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy. io@lucasconfienza.it.
³ Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, the Netherlands.
⁴ IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy.
⁵ Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy.
⁶ St Luke's Radiology Oxford Ltd, Oxford, UK.
⁷ University of Oxford, Oxford, UK.
⁸ Department of Radiology, Auckland City Hospital, Auckland, 1023, New Zealand.
⁹ Department of Radiology, Hospital Vithas Nueve de Octubre, 46015, Valencia, Spain.
¹⁰ Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy.
¹¹ Department of Radiology, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK.
¹² Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.
¹³ Department of Neurosciences, University of Genova, Genoa, Italy.
¹⁴ The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁵ Nuffield Orthopaedic Hospital, Oxford, UK.
¹⁶ UOC Radiologia, Ospedale di Feltre, AULSS 1 Dolomiti, Veneto, Italy.
¹⁷ Department of Radiology, Donostia University Hospital, Begiristain Doktorea Pasealekua, 109, 20014, Donostia/San Sebastian, Spain.
¹⁸ University of the Basque Country (UPV/EHU), Leioa, Spain.
¹⁹ Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, CE, Italy.
²⁰ Department of Musculoskeletal Radiology, Private Ultrasound Institution, Heraklion, Greece.
²¹ IBERORAD 1895 S.L., 08021, Barcelona, Spain.
²² Department of Radiology, General University Hospital of Valencia, Valencia, Spain.
²³ 2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Athens, Greece.
²⁴ University of Antwerp, University of Antwerp Hospital (UZA), Antwerp, Belgium.
²⁵ Università degli Studi di Milano, Milan, Italy.
²⁶ Leeds Teaching Hospitals, Leeds, UK.
²⁷ Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
²⁸ The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, UK.
²⁹ Hospital Son Llatzer, Palma de Mallorca, Spain.
³⁰ Universidad de las Islas Baleares, Palma, Spain.
³¹ DISSAL Department of Health Sciences, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
³² Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy.
³³ Oxford Musculoskeletal Radiology, Oxford, UK.
³⁴ Medical School of the National and Kapodistrian University of Athens, Athens, Greece.
³⁵ Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
³⁶ Department of Physiology, Universidad de Valencia/INCLIVA, Avenida Blasco Ibañez 15, 46010, Valencia, Spain.
³⁷ Herlev og Gentofte Hospital Radiologisk Afdeling, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark.
³⁸ Radiology, Ordensklinikum, Seilerstätte 4, 4020, Linz, Austria.
³⁹ Department of Oral Dentistry, Wroclaw Medical University, Wroclaw, Poland.
⁴⁰ Ospedale Evangelico Internazionale Genova, Genoa, Italy.
⁴¹ Department of Radiology, Private Institution of Ultrasonography, Athens, Greece.
⁴² POVISA Hospital, Vigo, Pontevedra, Spain.
⁴³ Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania.
⁴⁴ Institute of Radiology, University Medical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia.
⁴⁵ Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy.
⁴⁶ Department of Radiology, AUVA Trauma Centre, Vienna, Austria.
⁴⁷ Medical Faculty, University "Ss.Cyril and Methodius", Skopje, North Macedonia; University Surgical Clinic "St.Naum Ohridski", Skopje, North Macedonia.
⁴⁸ Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy.
⁴⁹ Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
⁵⁰ Varelli Institute, Naples, Italy.
⁵¹ Sint Maartenskliniek, 6500GM, 9011, Nijmegen, the Netherlands.

PMID: 31529252
DOI: 10.1007/s00330-019-06419-x

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 I, shoulder

Luca Maria Sconfienza et al. Eur Radiol. 2020 Feb.

. 2020 Feb;30(2):903-913.

doi: 10.1007/s00330-019-06419-x. Epub 2019 Sep 16.

Authors

Affiliations

¹ IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy. io@lucasconfienza.it.
² Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy. io@lucasconfienza.it.
³ Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Brunssum, Kerkrade, the Netherlands.
⁴ IRCCS Istituto Ortopedico Galeazzi, Unità Operativa di Radiologia Diagnostica ed Interventistica, 20161, Milan, Italy.
⁵ Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, 90127, Palermo, Italy.
⁶ St Luke's Radiology Oxford Ltd, Oxford, UK.
⁷ University of Oxford, Oxford, UK.
⁸ Department of Radiology, Auckland City Hospital, Auckland, 1023, New Zealand.
⁹ Department of Radiology, Hospital Vithas Nueve de Octubre, 46015, Valencia, Spain.
¹⁰ Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy.
¹¹ Department of Radiology, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK.
¹² Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy.
¹³ Department of Neurosciences, University of Genova, Genoa, Italy.
¹⁴ The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁵ Nuffield Orthopaedic Hospital, Oxford, UK.
¹⁶ UOC Radiologia, Ospedale di Feltre, AULSS 1 Dolomiti, Veneto, Italy.
¹⁷ Department of Radiology, Donostia University Hospital, Begiristain Doktorea Pasealekua, 109, 20014, Donostia/San Sebastian, Spain.
¹⁸ University of the Basque Country (UPV/EHU), Leioa, Spain.
¹⁹ Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, Castel Volturno, CE, Italy.
²⁰ Department of Musculoskeletal Radiology, Private Ultrasound Institution, Heraklion, Greece.
²¹ IBERORAD 1895 S.L., 08021, Barcelona, Spain.
²² Department of Radiology, General University Hospital of Valencia, Valencia, Spain.
²³ 2nd Department of Radiology, University General Hospital "ATTIKON" Medical School, National and Kapodistrian University of Athens, Athens, Greece.
²⁴ University of Antwerp, University of Antwerp Hospital (UZA), Antwerp, Belgium.
²⁵ Università degli Studi di Milano, Milan, Italy.
²⁶ Leeds Teaching Hospitals, Leeds, UK.
²⁷ Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
²⁸ The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry, UK.
²⁹ Hospital Son Llatzer, Palma de Mallorca, Spain.
³⁰ Universidad de las Islas Baleares, Palma, Spain.
³¹ DISSAL Department of Health Sciences, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy.
³² Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy.
³³ Oxford Musculoskeletal Radiology, Oxford, UK.
³⁴ Medical School of the National and Kapodistrian University of Athens, Athens, Greece.
³⁵ Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
³⁶ Department of Physiology, Universidad de Valencia/INCLIVA, Avenida Blasco Ibañez 15, 46010, Valencia, Spain.
³⁷ Herlev og Gentofte Hospital Radiologisk Afdeling, Herlev Ringvej 75, opgang 51, 2730, Herlev, Denmark.
³⁸ Radiology, Ordensklinikum, Seilerstätte 4, 4020, Linz, Austria.
³⁹ Department of Oral Dentistry, Wroclaw Medical University, Wroclaw, Poland.
⁴⁰ Ospedale Evangelico Internazionale Genova, Genoa, Italy.
⁴¹ Department of Radiology, Private Institution of Ultrasonography, Athens, Greece.
⁴² POVISA Hospital, Vigo, Pontevedra, Spain.
⁴³ Institute of Sport Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania.
⁴⁴ Institute of Radiology, University Medical Centre Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia.
⁴⁵ Department of Health Sciences, University of Genoa, Via A. Pastore 1, 16132, Genoa, Italy.
⁴⁶ Department of Radiology, AUVA Trauma Centre, Vienna, Austria.
⁴⁷ Medical Faculty, University "Ss.Cyril and Methodius", Skopje, North Macedonia; University Surgical Clinic "St.Naum Ohridski", Skopje, North Macedonia.
⁴⁸ Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy.
⁴⁹ Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
⁵⁰ Varelli Institute, Naples, Italy.
⁵¹ Sint Maartenskliniek, 6500GM, 9011, Nijmegen, the Netherlands.

PMID: 31529252
DOI: 10.1007/s00330-019-06419-x

Abstract

Background: Image-guided interventional procedures around the shoulder are commonly performed in clinical practice, although evidence regarding their effectiveness is scarce. We report the results of a Delphi method review of evidence on literature published on image-guided interventional procedures around the shoulder with a list of clinical indications.

Methods: Forty-five experts in image-guided musculoskeletal procedures from the ESSR participated in a consensus study using the Delphic method. Peer-reviewed papers regarding interventional procedures around the shoulder up to September 2018 were scored according to the Oxford Centre for Evidence-based Medicine levels of evidence. Statements on clinical indications were constructed. Consensus was considered as strong if more than 95% of experts agreed and as broad if more than 80% agreed.

Results: A total of 20 statements were drafted, and 5 reached the highest level of evidence. There were 10 statements about tendon procedures, 6 about intra-articular procedures, and 4 about intrabursal injections. Strong consensus was obtained in 16 of them (80%), while 4 received broad consensus (20%).

Conclusions: Literature evidence on image-guided interventional procedures around the shoulder is limited. A strong consensus has been reached for 80% of statements. The ESSR recommends further research to potentially influence treatment options, patient outcomes, and social impact.

Key points: • Expert consensus produced a list of 20 evidence-based statements on clinical indications of image-guided interventional procedures around the shoulder. • The highest level of evidence was reached for five statements. • Strong consensus was obtained for 16 statements (80%), while 4 received broad consensus (20%).

Keywords: Injections; Interventional radiology; Platelet-rich plasma; Shoulder; Ultrasonography.

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References

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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 I, shoulder

Affiliations

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 I, shoulder

Authors

Affiliations

Abstract

References

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LinkOut - more resources

Full Text Sources