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 VI, foot and ankle

Sconfienza, Luca Maria; Adriaensen, Miraude; Albano, Domenico; Alcalá-Galiano, Andrea; Allen, Georgina; Gómez, Maria Pilar Aparisi; Aringhieri, Giacomo; Bazzocchi, Alberto; Beggs, Ian; Chianca, Vito; Corazza, Angelo; Dalili, Danoob; Dea, Miriam De; Rodríguez, J.L. del Cura; Pietto, Francesco Di; Drakonaki, Eleni E.; Castro, Fernando; Filippiadis, Dimitrios; Gitto, Salvatore; Grainger, Andrew; Greenwood, Simon; Gupta, Harun; Isaac, Amanda; Ivanoski, Slavcho; Khanna, Monica; Klauser, Andrea; Mansour, Ramy; Martin, Silvia; Mascarenhas, Vasco; Mauri, Giovanni; McCarthy, Catherine; McKean, David; McNally, Eugene; Melaki, Kalliopi; Messina, Carmelo; Mombiela, Rebeca Mirón; Moutinho, Ricardo; Olchowy, Cyprian; Orlandi, Davide; González, R. Prada; Prakash, Mahesh; Posadzy, Magdalena; Rutkauskas, Saulius; Snoj, Žiga; Tagliafico, Alberto; Talaska, Alexander; Tomás, Xavier; Nikodinovska, Violeta Vasilevska; Vucetic, Jelena; Wilson, David J.; Zappia, Marcello; Obradov, Marina

doi:10.1007/s00330-021-08125-z

Cited by 28 publications

(26 citation statements)

References 97 publications

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“…None of the statements reached the highest level of evidence. Statements regarding image-guided interventional procedures to treat Morton’s neuroma have been reported in a separate paper [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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. Key Points • 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. The volume of local anesthetic affects the size of the blocked sensory area.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…This review addresses all these aspects but focuses on neglected technical concerns. Sconfienza, et al, report the results of a Delphi-based consensus of 53 experts from the European Society of Musculoskeletal Radiology (ESSR) [157]. The authors reviewed the literature for evidence on image-guided interventional procedures offered around foot and ankle to derive their clinical indications and drafted a list of statements.…”

Section: Ultrasoundmentioning

confidence: 99%

Hit and miss: The accuracy of intra-articular injections of the first metatarsophalangeal joint

Reilly

2022

J Int Foot Ankle

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Introduction: Therapeutic injections provide a treatment option for patients with joint and periarticular pain, those who are not surgical candidates, whom conservative treatment has failed, or those that are awaiting surgery. Injectable glucocorticoids are one of the most common therapeutic interventions in musculoskeletal healthcare and are widely used in pathologies of the first metatarsophalangeal joint. The aim of this paper is to highlight current concepts around first metatarsophalangeal joint injection injection accuracy. Anatomy: The first metatarsophalangeal joint is a condyloid synovial juncture and consists of the head of the first metatarsal, the base of the proximal phalanx, six muscles, eight ligaments and two sesamoid bones, with associated ligamentous attachments. The joint capsule is shaped like a box. Methods: To achieve the research aim, a scoping review was undertaken with a search strategy that identified evidence via the following sources: Electronic databases, Google scholar, and Reference lists. Results: The search yielded 193 articles, 48 of which appeared of potential relevance. After removing duplicate articles this total was reduced to 37 articles. After scanning the content, 27 were excluded to leave 10 articles. Twenty eight further articles were found through related author research, examination of reference lists and free text searches of Google Scholar. One reference was unobtainable. The final count of papers utilised for review was 37 which produced three themes, one of which was injection accuracy. Injection accuracy: In the long history of injection therapy, infiltrations have often been performed without image guidance, i.e., using palpation guidance, anatomical landmarks and clinical judgement to direct needle entry and advancement. Needle placement may also be confirmed by use of diagnostic imaging. Typical imaging modalities are fluoroscopy or ultrasound, used alone or in combination with contrast media. Discussion: The perceived wisdom is that if an injectate misses its target it is likely to be less effective and lead to false negative reporting of poor treatment outcomes, but the literature is not equivocal. This article discusses the recent literature in the field. Conclusions: The literature suggests that steroid injections are safe and effective for the short-term relief of joint pain. When injecting small synovial joints using palpated-guided methods, clinicians must be alert to the potential for failure of technique from the needle penetrating too far into the articulation and exiting the joint on the contralateral side from the entry point. Use of shorter needles and use of imaging, +/- the use of contrast media, might reduce the number of such failures.

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“…Imaging is routinely used to support clinical examination, with plain radiography being able to detect calcaneal spurs and PF calcifications/ ossifications, while ultrasound is applied to identify the increased thickness, hypoechoic texture, and any partial/ full-thickness tears [4]. Ultrasound is also used as guidance to increase the accuracy and effectiveness of interventional procedures to treat plantar fasciitis [5].…”

Section: Introductionmentioning

confidence: 99%

Shear-wave elastography of the plantar fascia: a systematic review and meta-analysis

et al. 2023

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Purpose To assess the efficacy of shear-wave elastography (SWE) of the plantar fascia (PF) in identifying plantar fasciitis. Methods A literature search was conducted on the PubMed and Medline databases for articles published up to August 2022. The Newcastle–Ottawa scale was used to assess the risk of bias. We included original research studies in English dealing with the evaluation of patients with plantar fasciitis by means of SWE and including shear modulus (KPa) and/or shear-wave velocity (m/s). We compared healthy and pathologic PF stiffness using the standardised mean difference (SMD) in a random-effects model (95% CI). Results Five studies were included with a total of 158 pathologic PFs and 134 healthy PFs. No significant publication bias was detected. Studies were highly heterogeneous (p < 0.00001; I2 = 97%). Pathologic PFs showed significantly lower stiffness, with an SMD of − 3.00 m/s (95% confidence interval: − 4.95 to − 1.06, p = 0.002), compared to healthy PF. Conclusion Pathologic PFs present significantly lower stiffness than healthy PFs. However, the analysed studies are highly heterogeneous.

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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 VI, foot and ankle

Cited by 28 publications

References 97 publications

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

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

Hit and miss: The accuracy of intra-articular injections of the first metatarsophalangeal joint

Shear-wave elastography of the plantar fascia: a systematic review and meta-analysis

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