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Interventional therapeutic procedures in the musculoskeletal system: an Italian Survey by the Italian College of Musculoskeletal Radiology

  • MUSCULOSKELETAL RADIOLOGY
  • Published:
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Abstract

Purpose

To perform an online survey among all members of the Italian College of Musculoskeletal Radiology to understand how therapeutic musculoskeletal procedures are performed in daily practice in Italy.

Methods

We administered an online survey to all 2405 members about the use of therapeutic musculoskeletal procedures in their institutions asking 16 different questions. Subgroup analysis was performed between general and orthopaedic hospitals with Mann–Whitney U and χ 2 statistics.

Results

A total of 129/2405 answers (5.4% of members) were included in our analysis. A median of 142.5 (25th–75th percentiles: 50–535.5; range 10–5000) therapeutic musculoskeletal procedures per single institution was performed in 2016. Arthropathic pain was the main indication. The most common procedures were joint injection, bursal/tendon injection, and irrigation of calcific tendinopathy. Ultrasound-guided procedures were mainly performed in ultrasonography rooms (77.4%) rather than in dedicated interventional rooms (22.6%). Conversely, fluoroscopic procedures were performed almost with the same frequency in interventional radiology suites (52.4%) and in general radiology rooms (47.6%). In most institutions (72%), autologous blood or components were not used. The median number of therapeutic musculoskeletal procedures performed in orthopaedic hospitals was significantly higher than in general hospitals (P = 0.002), as well as for the use of autologous preparations (P = 0.004).

Conclusion

Joint injection, bursal/tendon injection, and irrigation of calcific tendinopathy were the most common therapeutic musculoskeletal procedures, being arthropathic pain the main indication. The percentage of procedures and the use of autologous preparations were significantly higher in orthopaedic hospitals than in general hospitals.

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References

  1. Cazzato RL, Garnon J, Ramamurthy N et al (2016) Percutaneous image-guided cryoablation: current applications and results in the oncologic field. Med Oncol 33:140

    Article  PubMed  Google Scholar 

  2. Fabbro E, Ferrero G, Orlandi D et al (2012) Rotator cuff ultrasound-guided procedures: technical and outcome improvements. Imaging Med 6:649–656

    Article  Google Scholar 

  3. Masciocchi C, Conchiglia A, Gregori LM, Arrigoni F, Zugaro L, Barile A (2014) Critical role of HIFU in musculoskeletal interventions. Radiol Med 119:470–475

    Article  PubMed  Google Scholar 

  4. Messina C, Sconfienza LM (2016) Ultrasound-guided percutaneous irrigation of calcific tendinopathy. Semin Musculoskelet Radiol 20:409–413

    Article  PubMed  Google Scholar 

  5. Arrigoni F, Gregori LM, Zugaro L, Barile A, Masciocchi C (2014) MRgFUS in the treatment of MSK lesions: a review based on the experience of the university of L’Aquila, Italy. Transl Cancer Res 3:442–448

    Google Scholar 

  6. Messina C, Banfi G, Orlandi D et al (2016) Ultrasound-guided interventional procedures around the shoulder. Br J Radiol 89:20150372

    Article  PubMed  Google Scholar 

  7. Gompels BM, Darlington LG (1981) Septic arthritis in rheumatoid disease causing bilateral shoulder dislocation: diagnosis and treatment assisted by grey scale ultrasonography. Ann Rheum Dis 40:609–611

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kane D, Koski J (2016) Musculoskeletal interventional procedures: with or without imaging guidance? Best Pract Res Clin Rheumatol 30:736–750

    Article  PubMed  Google Scholar 

  9. Sconfienza LM, Mauri G, Messina C et al (2016) Ultrasound-guided percutaneous tenotomy of biceps tendon: technical feasibility on cadavers. Ultrasound Med Biol 42:2513–2517

    Article  PubMed  Google Scholar 

  10. Albano D, Chianca V, Tormenta S et al (2017) Old and new evidence concerning the crucial role of ultrasound in guiding intra-articular injections. Skeletal Radiol 46:963–964

    Article  PubMed  Google Scholar 

  11. Orlandi D, Corazza A, Arcidiacono A et al (2016) Ultrasound-guided procedures to treat sport-related muscle injuries. Br J Radiol 89:20150484

    Article  PubMed  Google Scholar 

  12. Messina C, Banfi G, Aliprandi A et al (2016) Ultrasound guidance to perform intra-articular injection of gadolinium-based contrast material for magnetic resonance arthrography as an alternative to fluoroscopy: the time is now. Eur Radiol 26:1221–1225

    Article  PubMed  Google Scholar 

  13. Messina C, Orlandi D, Sconfienza LM (2016) Do we still need fluoroscopy to perform injections in the musculoskeletal system? Skeletal Radiol 45:1717–1718

    Article  PubMed  Google Scholar 

  14. Arrigoni F, Barile A, Zugaro L et al (2017) CT-guided radiofrequency ablation of spinal osteoblastoma: treatment and long-term follow-up. Int J Hyperthermia 9:1–7. https://doi.org/10.1080/02656736.2017.1334168

    Article  Google Scholar 

  15. Barile A, Arrigoni F, Zugaro L et al (2017) Minimally invasive treatments of painful bone lesions: state of the art. Med Oncol 34:53

    Article  PubMed  Google Scholar 

  16. Masciocchi C, Zugaro L, Arrigoni F et al (2016) Radiofrequency ablation versus magnetic resonance guided focused ultrasound surgery for minimally invasive treatment of osteoid osteoma: a propensity score matching study. Eur Radiol 26:2472–2481

    Article  PubMed  Google Scholar 

  17. Masciocchi C, Arrigoni F, Marra AL, Mariani S, Zugaro L, Barile A (2016) Treatment of focal benign lesions of the bone: mRgFUS and RFA. Br J Radiol 89:20150356

    Article  PubMed  PubMed Central  Google Scholar 

  18. Albano D, Messina C, Usuelli FG et al (2017) Magnetic resonance and ultrasound in achilles tendinopathy: predictive role and response assessment to platelet-rich plasma and adipose-derived stromal vascular fraction injection. Eur J Radiol 95:130–135

    Article  PubMed  Google Scholar 

  19. Orlandi D, Mauri G, Lacelli F et al (2017) Rotator cuff calcific tendinopathy: randomized comparison of US-guided percutaneous treatments by using one or two needles. Radiology 285:518–527

    Article  PubMed  Google Scholar 

  20. Sartoris R, Orlandi D, Corazza A et al (2017) In vivo feasibility of real-time MR-US fusion imaging lumbar facet joint injections. J Ultrasound 20:23–31

    Article  PubMed  PubMed Central  Google Scholar 

  21. Barile A, La Marra A, Arrigoni F et al (2016) Anaesthetics, steroids and platelet-rich plasma (PRP) in ultrasound-guided musculoskeletal procedures. Br J Radiol 89:20150355

    Article  PubMed  PubMed Central  Google Scholar 

  22. Tagliafico A, Russo G, Boccalini S et al (2014) Ultrasound-guided interventional procedures around the shoulder. Radiol Med 119:318–326

    Article  PubMed  Google Scholar 

  23. Bruno F, Smaldone F, Varrassi M et al (2017) MRI findings in lumbar spine following O2-O3 chemiodiscolysis: a long-term follow-up. Interv Neuroradiol 23:444–450

    Article  PubMed  Google Scholar 

  24. Arrigoni F, Barile A, Zugaro L et al (2017) Intra-articular benign bone lesions treated with Magnetic Resonance-guided Focused Ultrasound (MRgFUS): imaging follow-up and clinical results. Med Oncol 34:55

    Article  PubMed  Google Scholar 

  25. Barile A, Bruno F, Mariani S et al (2017) Follow-up of surgical and minimally invasive treatment of Achilles tendon pathology: a brief diagnostic imaging review. Musculoskelet Surg 101:51–61

    Article  CAS  PubMed  Google Scholar 

  26. https://docs.google.com/forms/. Accessed 1 December 2017

  27. Cunnington J, Marshall N, Hide G et al (2010) A randomized, double-blind, controlled study of ultrasound-guided corticosteroid injection into the joint of patients with inflammatory arthritis. Arthritis Rheum 62:1862–1869

    PubMed  Google Scholar 

  28. Smith J, Brault JS, Rizzo M et al (2011) Accuracy of sonographically guided and palpation guided scaphotrapeziotrapezoid joint injections. J Ultrasound Med 30:1509–1515

    Article  PubMed  Google Scholar 

  29. Hashiuchi T, Sakurai G, Morimoto M et al (2011) Accuracy of the biceps tendon sheath injection: ultrasound-guided or unguided injection? A randomized controlled trial. J Shoulder Elb Surg 20:1069–1073

    Article  Google Scholar 

  30. Lanza E, Banfi G, Serafini G (2015) Ultrasound-guided percutaneous irrigation in rotator cuff calcific tendinopathy: what is the evidence? A systematic review with proposals for future reporting. Eur Radiol 25:2176–2183

    Article  PubMed  Google Scholar 

  31. Sconfienza LM, Viganò S, Martini C et al (2013) Double-needle ultrasound-guided percutaneous treatment of rotator cuff calcific tendinitis: tips & tricks. Skeletal Radiol 42:19–24

    Article  PubMed  Google Scholar 

  32. Sconfienza LM, Bandirali M, Serafini G et al (2012) Rotator cuff calcific tendinitis: does warm saline solution improve the short-term outcome of double-needle US-guided treatment? Radiology 262:560–566

    Article  PubMed  Google Scholar 

  33. Lacelli F, Muda A, Sconfienza LM, Schettini D, Garlaschi G, Silvestri E (2008) High-resolution ultrasound anatomy of extrinsic carpal ligaments. Radiol Med 113:504–516

    Article  CAS  PubMed  Google Scholar 

  34. Randelli F, Brioschi M, Randelli P, Ambrogi F, Sdao S, Aliprandi A (2017) Fluoroscopy- vs ultrasound-guided aspiration techniques in the management of periprosthetic joint infection: which is the best? Radiol Med. https://doi.org/10.1007/s11547-017-0811-1

    PubMed  Google Scholar 

  35. Raeissadat SA, Rayegani SM, Hassanabadi H et al (2015) Knee osteoarthritis injection choices: platelet-rich plasma (prp) versus hyaluronic acid (a one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskelet Disord 8:1–8

    Article  PubMed  PubMed Central  Google Scholar 

  36. Malavolta EA, Gracitelli ME, Ferreira Neto AA et al (2014) Platelet-rich plasma in rotator cuff repair: a prospective randomized study. Am J Sports Med 42:2446–2454

    Article  PubMed  Google Scholar 

  37. Andia I, Latorre PM, Gomez MC et al (2014) Platelet-rich plasma in the conservative treatment of painful tendinopathy: a systematic review and meta-analysis of controlled studies. Br Med Bull 110:99–115

    Article  CAS  PubMed  Google Scholar 

  38. Sheth U, Simunovic N, Klein G et al (2012) Efficacy of autologous platelet-rich plasma use for orthopaedic indications: a meta-analysis. J Bone Joint Surg Am 94:298–307

    Article  PubMed  Google Scholar 

  39. Gross CE, Hsu AR, Chahal J, Holmes GB Jr (2013) Injectable treatments for noninsertional Achilles tendinosis: a systematic review. Foot Ankle Int 34:619–628

    Article  PubMed  Google Scholar 

  40. Albano D, Martinelli N, Bianchi A, Giacalone A, Sconfienza LM (2017) Evaluation of reproducibility of the MOCART score in patients with osteochondral lesions of the talus repaired using the autologous matrix-induced chondrogenesis technique. Radiol Med 122:909–917

    Article  PubMed  Google Scholar 

  41. Albano D, Martinelli N, Bianchi A, Messina C, Malerba F, Sconfienza LM (2017) Clinical and imaging outcome of osteochondral lesions of the talus treated using autologous matrix-induced chondrogenesis technique with a biomimetic scaffold. BMC Musculoskelet Disord 18:306

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ferrero G, Fabbro E, Orlandi D et al (2012) Ultrasound-guided injection of platelet-rich plasma in chronic Achilles and patellar tendinopathy. J Ultrasound 15:260–266

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Sconfienza LM, Albano D, Messina C, Silvestri E, Tagliafico AS (2017) How, when, why in magnetic resonance arthrography: an International Survey by the European Society of Musculoskeletal Radiology (ESSR). Eur Radiol in press. https://doi.org/10.1007/s00330-017-5208-y

    Google Scholar 

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Acknowledgements

Italian College of Musculoskeletal Radiology. Enzo Silvestri is current and Antonio Barile is elected chair of the Musculoskeletal College. Authors want to thank all members who completed the survey in full and gave their consent to publish their names: Alessio Angileri, Francesco Arrigoni, Angelo Asciano, Raffaele Averna, Francesco Bartelli, Alberto Bellelli, Massimo Giuliano Bonetti, Mario Canepari, Rinaldo Capoccia, Cristian Caporali, Emanuele Ciarcià, Federico Ciolina, Paolo Comes, Armando Conchiglia, Luca De Flaviis, Pierluigi De Matteis, Paola Erra, Gianluigi Di Giulio, Marilene Eccher, Carlo Faletti, Giampiero Feltrin, Gisella Ferretti, Giovanni Foti, Michele Liotti, Alessandro Lupi, Nicola Magarelli, Daniele Maiettini, Giorgia Manfredonia, Sabino Mangino, Fabio Melchiorre, Davide Monti, Giovanni Musella, Alessandro Napoli, Mauro Niccolini, Dario Notaro, Giulio Pasquotti, Luciano Perini, Caterina Peroni, Lucia Pinali, Vincenzo Pipitone, Stefano Romiti, Domiziana Santucci, Giancarlo Sarnelli, Giuseppe Sarti, Germano Scevola, Marco Scrocca, Casimiro Simonetti, Michele Solarino, Giulio Vallati, Carlo Zanolini.

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Authors and Affiliations

  1. Unit of Radiology, Ospedale Evangelico Internazionale, Piazzale Gianasso 5, 16100, Genoa, Italy

    Enzo Silvestri & Davide Orlandi

  2. Department of Biotechnology and Applied Clinical Science, University of L’Aquila, L’Aquila, Italy

    Antonio Barile, Luigi Zugaro & Carlo Masciocchi

  3. Department of Radiology, Di.Bi.Med., University of Palermo, Via del Vespro 127, 90127, Palermo, Italy

    Domenico Albano

  4. Unità Operativa di Radiologia Diagnostica ed Interventistica, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy

    Carmelo Messina, Angelo Corazza & Luca Maria Sconfienza

  5. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy

    Luca Maria Sconfienza

  6. S.C. Diagnostica per Immagini e Ecografia Interventistica, Ospedale Evangelico Internazionale di Genova, Salita Superiore San Rocchio 31/A, 16122, Genoa, Italy

    Enzo Silvestri & Davide Orlandi

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  1. Enzo Silvestri
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  2. Antonio Barile
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  4. Carmelo Messina
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  9. Luca Maria Sconfienza
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Corresponding author

Correspondence to Luca Maria Sconfienza.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study ethical approval and patients’ consent were not required.

Funding

No funding was obtained for the present study.

Conflict of interest

All authors are members of the Musculoskeletal College of the Italian Society of Medical and Interventional Radiology. Enzo Silvestri is current and Antonio Barile is elected chair of the Musculoskeletal College. All other authors have no conflict of interest to disclose. Institutional review board approval was not needed for the present paper as patients are not involved.

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Silvestri, E., Barile, A., Albano, D. et al. Interventional therapeutic procedures in the musculoskeletal system: an Italian Survey by the Italian College of Musculoskeletal Radiology. Radiol med 123, 314–321 (2018). https://doi.org/10.1007/s11547-017-0842-7

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  • DOI: https://doi.org/10.1007/s11547-017-0842-7

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