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

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Ultrasound elastography (USE) is becoming an important adjunct tool in the evaluation of various musculoskeletal (MSK) traumatic conditions and diseases, with an increasing number of applications and publications in recent years. This rapidly evolving technique enhances the conventional ultrasound (US) examination by providing information on the elastic properties of tissue alongside the morphological and vascular information obtained from B-mode US and Doppler imaging. Those performing USE must have basic knowledge of its proper imaging techniques and limitations. In this review article, we place the USE in historical perspective and discuss basic techniques and current applications of USE in the evaluation of various traumatic and pathologic conditions of fasciae, nerves, muscles, tendons, ligaments, and MSK soft tissue masses.

Section: Nervesmentioning

confidence: 99%

Ultrasound Elastography in Musculoskeletal Radiology: Past, Present, and Future

Snoj

Taljanovic

et al. 2020

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“…26 ESSR is moving in this direction by offering MSK US guidelines, up-to-date MSK US publications, and promoting ongoing US education through the organization of various MSK US courses. [27][28][29][30] The EFSUMB proposed minimum training requirements for rheumatologists practicing MSK US in Europe with a three-level competency assessment. 31 However, official qualifications for nonradiologists to perform MSK US are necessary in only 21% of the respondent countries.…”

Section: Discussionmentioning

confidence: 99%

Present Status of Musculoskeletal Radiology in Europe: International Survey by the European Society of Musculoskeletal Radiology

Snoj

Hebar

Sconfienza

et al. 2020

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No official data exist on the status of musculoskeletal (MSK) radiology in Europe. The Committee for National Societies conducted an international survey to understand the status of training, subspecialization, and local practice among the European Society of Musculoskeletal Radiology (ESSR) partner societies. This article reports the results of that survey. An online questionnaire was distributed to all 26 European national associations that act as official partner societies of the ESSR. The 24 questions were subdivided into six sections: society structure, relationship with the national radiological society, subspecialization, present radiology practice, MSK interventional procedures, and MSK ultrasound. The findings of our study show a lack of standardized training and/or accreditation methods in the field of MSK radiology at a national level. The European diploma in musculoskeletal radiology is directed to partly overcome this problem; however, this certification is still underrecognized. Using certification methods, a more homogeneous European landscape could be created in the future with a view to subspecialist training. MSK ultrasound and MSK interventional procedures should be performed by a health professional with a solid knowledge of the relevant imaging modalities and sufficient training in MSK radiology. Recognition of MSK radiology as an official subspecialty would make the field more attractive for younger colleagues as well as attracting the brightest and best, an important key to further development of both clinical and academic radiology. Key Points

“…US is also useful as a guidance for both diagnostic and therapeutic purposes. 52,53 In acute settings, US features of flexor tenosynovitis (►Fig. S5) include hypo-or anechoic effusion within the synovial sheath, thickening of the tenosynovium with hyperemia, thickening and loss of fibrillar echotexture of the involved tendon, and in some cases peritendinous edema.…”

Section: Tenosynovitis Of Flexor Tendonsmentioning

confidence: 99%

Pulley, Flexor, and Extensor Tendon Injuries of the Hand

Rosskopf

Taljanovic

Sconfienza

et al. 2021

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Tendon injuries represent the second most common injury of the hand (after fractures) and are a common scanning indication in radiology. Pulley injuries are very frequent in rock climbers with the A2 pulley the most commonly affected. Tendon and pulley injuries can be reliably evaluated using ultrasound (US) and magnetic resonance imaging (MRI). US can be postulated as a first-line imaging modality, allowing dynamic examination. MRI is essential for cases with ongoing diagnostic doubt post-US and also for preoperative pulley reconstruction assessment.