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| European radiology. 2019 Nov 11. doi: 10.1007/s00330-019-06479-z. pii: 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. |
| Sconfienza LM1, Adriaensen M2, Albano D3, Allen G4, Aparisi Gómez MP5, Bazzocchi A6, Beggs I7, Bignotti B8, Chianca V9, Corazza A10, Dalili D11, De Dea M12, Del Cura JL13, Di Pietto F14, Drakonaki E15, Facal de Castro F16, Filippiadis D17, Gielen J18, Gitto S19, Gupta H20, Klauser AS21, Lalam R22, Martin S23, Martinoli C24, Mauri G25, McCarthy C26, McNally E27, Melaki K28, Messina C29, Mirón Mombiela R30, Neubauer B31, Obradov M32, Olchowy C33, Orlandi D34, Gonzalez RP35, Rutkauskas S36, Snoj Z37, Tagliafico AS38, Talaska A39, Vasilevska-Nikodinovska V40, Vucetic J41, Wilson D42, Zaottini F43, Zappia M44, Plagou A45 |
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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%). |
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KEYWORDS: Injections; Steroids, Peripheral nerves, Radiology, interventional, Ultrasonography |
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Publikations ID: 31712960 Quelle: öffnen |
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