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.
Authors
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
Ivanoski, Slavcho
Khanna, Monica
Klauser, Andrea
Mansour, Ramy
Martin, Silvia
Mascarenhas, Vasco
Mauri, Giovanni
McCarthy, Catherine
McKean, David
McNally, Eugene
Melaki, Kalliopi
Messina, Carmelo
Miron 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
Isaac, Amanda
Publication Date
2022-03Journal Title
Eur Radiol
ISSN
0938-7994
Publisher
Springer Science and Business Media LLC
Volume
32
Issue
3
Pages
1456-1464
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Sconfienza, L. M., Adriaensen, M., Albano, D., Alcala-Galiano, A., Allen, G., Aparisi Gómez, M. P., Aringhieri, G., et al. (2022). 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.. Eur Radiol, 32 (3), 1456-1464. https://doi.org/10.1007/s00330-021-08283-0
Description
Funder: Università degli Studi di Milano
Abstract
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.
Keywords
Musculoskeletal, Interventional radiology, Ultrasonography, Nerves, Lidocaine, Corticosteroid
Identifiers
s00330-021-08283-0, 8283
External DOI: https://doi.org/10.1007/s00330-021-08283-0
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333922
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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