Identifier to cite or link to this item: https://hdl.handle.net/20.500.13003/19502
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
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AuthorSconfienza, Luca Maria; Adriaensen, Miraude; Albano, Domenico; Alcala-Galiano, andrea; Allen, Georgina; Aparisi Gomez, 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 Gonzalez, Raquel; Prakash, Mahesh; Posadzy, Magdalena; Rutkauskas, Saulius; Snoj, Ziga; Tagliafico, Alberto Stefano; Talaska, Alexander; Tomas, Xavier; Vasilevska Nikodinovska, Violeta; Vucetic, Jelena; Wilson, David; Zaottini, Federico; Zappia, Marcello; Isaac, Amanda
Document typeresearch article
CitationSconfienza LM, Adriaensen M, Albano D, Alcala-Galiano A, Allen G, Gomez MPA, et al. 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. 2022 Mar;32(3):1456-64.
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.