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.
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Sconfienza Luca Maria, Adriaensen Miraude, Albano Domenico, Alcala-Galiano Andrea, Allen Georgina, Aparisi Gómez Maria Pilar, Aringhieri Giacomo, Bazzocchi Alberto, Beggs Ian, Chianca Vito, Corazza Angelo, Dalili Danoob, De Dea Miriam, Del Cura Jose Luis, Di Pietto Francesco, Drakonaki Elena, Facal de Castro Fernando, Filippiadis Dimitrios, Gitto Salvatore, Grainger Andrew J, 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, Mirón Mombiela Rebeca, Moutinho Ricardo, Olchowy Cyprian, Orlandi Davide, Prada González Raquel, Prakash Mahesh, Posadzy Magdalena, Rutkauskas Saulius, Snoj Žiga, Tagliafico Alberto Stefano, Talaska Alexander, Tomas Xavier, Vasilevska Nikodinovska Violeta, Vucetic Jelena, Wilson David, Zaottini Federico, Zappia Marcello, Obradov Marina
Аннотация
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 foot and ankle in order 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 that was shared with all panel members for final approval.
RESULTS: A list of 16 evidence-based statements on clinical indications for image-guided musculoskeletal interventional procedures in the foot and ankle were drafted after a literature review. The highest level of evidence was reported for four statements, all receiving 100% agreement.
CONCLUSION: According to this consensus, image-guided interventions should not be considered a first-level approach for treating Achilles tendinopathy, while ultrasonography guidance is strongly recommended to improve the efficacy of interventional procedures for plantar fasciitis and Morton's neuroma, particularly using platelet-rich plasma and corticosteroids, respectively.
KEY POINTS: • The expert panel of the ESSR listed 16 evidence-based statements on clinical indications of image-guided musculoskeletal interventional procedures in the foot and ankle. • Strong consensus was obtained for all statements. • The highest level of evidence was reached by four statements concerning the effectiveness of US-guided injections of corticosteroid for Morton's neuroma and PRP for plantar fasciitis.