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Open Access 01-02-2022 | Musculoskeletal Radiology | Musculoskeletal

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

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

Published in: European Radiology | Issue 2/2022

Abstract

Objectives

Clarity regarding accuracy and effectiveness for interventional procedures around the foot and ankle is lacking. Consequently, a board of 53 members of the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the published literature to evaluate the evidence on image-guided musculoskeletal interventional procedures around this anatomical region.

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.

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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 VI, foot and ankle
Authors: Luca Maria Sconfienza
Miraude Adriaensen
Domenico Albano
Andrea Alcala-Galiano
Georgina Allen
Maria Pilar Aparisi Gómez
Giacomo Aringhieri
Alberto Bazzocchi
Ian Beggs
Vito Chianca
Angelo Corazza
Danoob Dalili
Miriam De Dea
Jose Luis del Cura
Francesco Di Pietto
Elena Drakonaki
Fernando Facal de Castro
Dimitrios Filippiadis
Salvatore Gitto
Andrew J Grainger
Simon Greenwood
Harun Gupta
Amanda Isaac
Slavcho Ivanoski
Monica Khanna
Andrea Klauser
Ramy Mansour
Silvia Martin
Vasco Mascarenhas
Giovanni Mauri
Catherine McCarthy
David McKean
Eugene McNally
Kalliopi Melaki
Carmelo Messina
Rebeca Mirón Mombiela
Ricardo Moutinho
Cyprian Olchowy
Davide Orlandi
Raquel Prada González
Mahesh Prakash
Magdalena Posadzy
Saulius Rutkauskas
Žiga Snoj
Alberto Stefano Tagliafico
Alexander Talaska
Xavier Tomas
Violeta Vasilevska Nikodinovska
Jelena Vucetic
David Wilson
Federico Zaottini
Marcello Zappia
Marina Obradov
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Keywords: Musculoskeletal Radiology
Plantar Fasciitis
Published in: European Radiology / Issue 2/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-08125-z

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Springer Medicine

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

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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