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.

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.

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 V, knee.

Objectives: Interventional procedures around the knee are widely adopted for treating different musculoskeletal conditions. A panel of experts from the Ultrasound and Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) reviewed the existing literature to assess the evidence on image-guided musculoskeletal interventional procedures around the knee, with the goal of highlighting some controversies associated with these procedures, specifically the role of imaging guidance, as well as the efficacy of the medications routinely injected.

Methods: We report the results of a Delphi-based consensus of 53 experts in musculoskeletal radiology, who reviewed the published literature for evidence on image-guided interventional procedures around the knee to derive a list of pertinent clinical indications.

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.

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.

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 IV, hip.

Objectives: Image-guided musculoskeletal interventional procedures around the hip are widely used in daily clinical practice. The need for clarity concerning the actual added value of imaging guidance and types of medications to be offered led the Ultrasound and the Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) to promote, with the support of its Research Committee, a collaborative project to review the published literature on image-guided musculoskeletal interventional procedures in the lower limb in order to derive a list of clinical indications.

Methods: In this article, we report the results of a Delphi-based consensus of 53 experts who reviewed the published literature for evidence on image-guided interventional procedures offered in the joint and soft tissues around the hip in order of their clinical indications.

US-guided Localization and Removal of Soft-Tissue Foreign Bodies.

US-guided foreign body removal is a nonsurgical highly effective technique used to manage symptomatic foreign bodies and should be considered as a first-line treatment procedure. The authors describe a technique used for US detection and US-guided removal of various types of foreign bodies and discuss the efficacy of the procedure. Soft-tissue foreign bodies can result from accidents or medical procedures, and they are a relatively frequent reason that patients obtain medical consultation.

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 II, elbow and wrist.

Background: Although image-guided interventional procedures of the elbow and wrist are routinely performed, there is poor evidence in the literature concerning such treatments. Our aim was to perform a Delphi-based consensus on published evidence on image-guided interventional procedures around the elbow and wrist and provide clinical indications on this topic.

Methods: A board of 45 experts in image-guided interventional musculoskeletal procedures from the European Society of Musculoskeletal Radiology were involved in this Delphi-based consensus study.

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 III, nerves of the upper limb.

Background: Image-guided interventional procedures of the nerves are commonly performed by physicians from different medical specialties, although there is a lack of clinical indications for these types of procedures. This Delphi-based consensus provided a list of indications on image-guided interventional procedures for nerves of the upper limb based on updated published evidence.

Methods: An expert panel of 45 members of the Ultrasound and Interventional Subcommittees of the ESSR participated in this Delphi-based consensus study.

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 I, shoulder.

Background: Image-guided interventional procedures around the shoulder are commonly performed in clinical practice, although evidence regarding their effectiveness is scarce. We report the results of a Delphi method review of evidence on literature published on image-guided interventional procedures around the shoulder with a list of clinical indications.

Methods: Forty-five experts in image-guided musculoskeletal procedures from the ESSR participated in a consensus study using the Delphic method.

Core-needle biopsy in thyroid nodules: performance, accuracy, and complications.

Objective: To evaluate the performance of core-needle biopsy (CNB) in thyroid using a cohort of patients in which it was used as first choice.

Methods: Our institutional review board approved this retrospective study. We reviewed all CNB performed in our center over a period of 11 years.

Ultrasound-guided core-needle biopsy in thyroid nodules. A study of 676 consecutive cases with surgical correlation.

Objectives: To analyze the diagnostic accuracy of ultrasound-guided core-needle biopsy (CNB) of thyroid nodules.

Methods: Of 3517 CNBs performed using an 18G spring-loaded device in one institution, we retrospectively reviewed 676 nodules in 629 consecutive patients who underwent surgery. CNB and pathological examination were compared.

Calcific tendinitis: a pictorial review.

Calcific tendinitis is caused by the pathologic deposition of calcium hydroxyapatite crystals in tendons and is a common cause of joint pain. The disease typically affects the shoulder and hip, with characteristic imaging findings; however, any joint can be involved. Occasionally, calcific tendinitis can mimic aggressive disorders, such as infection and neoplasm, especially on magnetic resonance imaging.

Ultrasound-guided therapeutic procedures in the musculoskeletal system.

Ultrasound allows the exploration of most of the musculoskeletal system, including lytic bone lesions. Its flexibility, availability, and low cost make it the best tool to guide interventional therapeutic procedures in any musculoskeletal system lesion visible on ultrasound. These techniques include drainages of abscesses, bursitis, hematomas or muscular strains, treatment of cystic lesions (ganglions, Baker's cysts), arthrocentesis, injection of substances in joints and soft tissues, and aspiration of calcific tendinitis.

Sonographically guided percutaneous needle lavage in calcific tendinitis of the shoulder: short- and long-term results.

Objective: The purpose of our study was to evaluate the short- and long-term effectiveness of sonographically guided percutaneous needle aspiration and lavage in calcific tendinitis of the shoulder and to study the progress of calcifications and symptoms in the first year after treatment.

Materials And Methods: Symptoms and radiologic findings after percutaneous aspiration of calcific tendinitis were prospectively evaluated in the short and the long term using a shoulder pain and disability index, evaluation of shoulder motion, and a survey of the self-perception by the patients regarding the progress of their disease.

Results: Sixty-seven consecutive shoulders were treated.

CT venography vs ultrasound in the diagnosis of thromboembolic disease in patients with clinical suspicion of pulmonary embolism.

To assess the reliability of indirect computed tomography venography (CTV) in the detection of deep venous thrombosis (DVT) in patients with clinical suspicion of pulmonary embolism (PE). 235 consecutive patients with suspicion of PE underwent an imaging protocol composed of a CT pulmonary angiography (CTPA), a CTV and an ultrasound study of the deep venous system, which was considered the "gold standard." Sensitivity, specificity, and predictive values were calculated for CTV.

Role of ultrasound-guided core biopsy in the evaluation of spleen pathology.

Core biopsy has not traditionally been recommended in the study of spleen nodules due to the supposed fragility of this organ leading to a high risk of post-core biopsy complications. A total of 13 patients who presented solid spleen nodules, diffuse splenomegaly, or both on imaging studies (CT, MR, US) were biopsied under ultrasound control with 18G BioPince needles. Cytological (imprints and cytocentrifugates) and histological material were obtained for diagnosis in every case.

Usefulness and limitations of ultrasound-guided core biopsy in the diagnosis of musculoskeletal tumours.

Ultrasound-guided needle biopsy is a safe and efficient diagnostic method increasingly used in the initial approach to superficial and deep musculoskeletal tumours. However, so far no general consensus has been reached regarding its reliability. During a 6-year period (1999-2004), biopsies were taken from 188 patients (100 females, 88 males; age average 55.

The use of unenhanced Doppler sonography in the evaluation of solid breast lesions.

Objective: The objectives of our study were to investigate differences in Doppler sonography features between benign and malignant breast lesions and between malignant lesions with different prognostic factors and to propose diagnostic criteria for Doppler sonography of breast lesions.

Subjects And Methods: We performed power and duplex Doppler sonography examinations in 826 breast lesions scheduled for sonographically guided core needle biopsy. Lesion vascularity, pulsatility index (PI), and resistive index (RI) of the vessels detected were analyzed and correlated with histologic results.