Skip to main content
SpringerLink
Log in

Interventional therapeutic procedures to treat degenerative and inflammatory musculoskeletal conditions: state of the art

  • MUSCULOSKELETAL RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Imaging-guided interventional procedures have become increasingly popular in the treatment of several pathologic conditions in the musculoskeletal system. Besides oncological treatments, musculoskeletal procedures can be performed to treat different degenerative or inflammatory conditions. This paper is aimed to review clinical indications and technical aspects of these kinds of procedures. In particular, we revise the general aspects common to most procedures and the different imaging-guided interventions which can be performed around joints, soft tissues, and spine.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Messina C, Orlandi D, Sconfienza LM (2016) Do we still need fluoroscopy to perform injections in the musculoskeletal system? Skeletal Radiol 45:1717–1718. https://doi.org/10.1007/s00256-016-2488-2

    Article  PubMed  Google Scholar 

  2. Sconfienza LM, Albano D, Allen G et al (2018) Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus. Eur Radiol. https://doi.org/10.1007/s00330-018-5474-3

    Article  PubMed  Google Scholar 

  3. 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. https://doi.org/10.1007/s00256-017-2644-3

    Article  PubMed  Google Scholar 

  4. 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. https://doi.org/10.1007/s00330-015-3945-3

    Article  PubMed  Google Scholar 

  5. del Cura JL, Zabala R, Corta I (2010) Ultrasound-guided interventional procedures in the musculoskeletal system. Radiol (English Ed) 52:525–533. https://doi.org/10.1016/S2173-5107(10)70026-4

    Article  Google Scholar 

  6. Hansford B, Stacy G (2012) Musculoskeletal Aspiration Procedures. Semin Intervent Radiol 29:270–285. https://doi.org/10.1055/s-0032-1330061

    Article  PubMed  PubMed Central  Google Scholar 

  7. Colio SW, Smith J, Pourcho AM (2016) Ultrasound-guided interventional procedures of the wrist and hand. Phys Med Rehabil Clin N Am 27:589–605. https://doi.org/10.1016/j.pmr.2016.04.003

    Article  PubMed  Google Scholar 

  8. Thornburg LE (1999) Ganglions of the hand and wrist. J Am Acad Orthop Surg 7:231–238

    Article  CAS  Google Scholar 

  9. Blackwell JR, Hay BA, Bolt AM, Hay SM (2014) Olecranon bursitis: a systematic overview. Shoulder Elb 6:182–190. https://doi.org/10.1177/1758573214532787

    Article  Google Scholar 

  10. García-Porrúa C, González-Gay MA, Ibañez D, García-País MJ (1999) The clinical spectrum of severe septic bursitis in northwestern Spain: a 10 year study. J Rheumatol 26:663–667

    PubMed  Google Scholar 

  11. Sconfienza LM, Randelli F, Sdao S et al (2014) Septic bursitis after ultrasound-guided percutaneous treatment of rotator cuff calcific tendinopathy. PM&R 6:746–748. https://doi.org/10.1016/j.pmrj.2014.01.004

    Article  Google Scholar 

  12. Weinstein PS, Canoso JJ, Wohlgethan JR (1984) Long-term follow-up of corticosteroid injection for traumatic olecranon bursitis. Ann Rheum Dis 43:44–46

    Article  CAS  Google Scholar 

  13. Mitchell AWM, Lee JC, Healy JC (2009) The use of ultrasound in the assessment and treatment of Achilles tendinosis. J Bone Jt Surg Br 91:1405–1409. https://doi.org/10.1302/0301-620X.91B11.23060

    Article  CAS  Google Scholar 

  14. Del Buono A, Battery L, Denaro V et al (2011) Tendinopathy and Inflammation: some Truths. Int J Immunopathol Pharmacol 24:45–50. https://doi.org/10.1177/03946320110241S209

    Article  PubMed  Google Scholar 

  15. Lanza E, Banfi G, Serafini G et al (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. https://doi.org/10.1007/s00330-014-3567-1

    Article  PubMed  Google Scholar 

  16. 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. https://doi.org/10.1148/radiol.11111157

    Article  PubMed  Google Scholar 

  17. Orlandi D, Fabbro E, Mauri G et al (2013) RE: a simple technique to restore needle patency during percutaneous lavage and aspiration of calcific rotator cuff tendinopathy. PM&R 5:633. https://doi.org/10.1016/j.pmrj.2013.04.018

    Article  Google Scholar 

  18. Chianca V, Albano D, Messina C et al (2018) Rotator cuff calcific tendinopathy: from diagnosis to treatment. Acta Biomed 89:186–196

    PubMed  PubMed Central  Google Scholar 

  19. Fabbro E, Ferrero G, Orlandi D et al (2012) Rotator cuff ultrasound-guided procedures: technical and outcome improvements. Imaging Med 4:649–656. https://doi.org/10.2217/iim.12.57

    Article  CAS  Google Scholar 

  20. Serafini G, Sconfienza LM (2012) Treatment of calcific tendinitis of the rotator cuff. Ultrasound-guided musculoskeletal procedures. Springer Milan, Milano, pp 29–35

    Chapter  Google Scholar 

  21. Messina C, Sconfienza LM (2016) Ultrasound-guided percutaneous irrigation of calcific tendinopathy. Semin Musculoskelet Radiol 20:409–413. https://doi.org/10.1055/s-0036-1594285

    Article  PubMed  Google Scholar 

  22. Merolla G, Singh S, Paladini P, Porcellini G (2016) Calcific tendinitis of the rotator cuff: state of the art in diagnosis and treatment. J Orthop Traumatol 17:7–14. https://doi.org/10.1007/s10195-015-0367-6

    Article  PubMed  Google Scholar 

  23. Cacchio A, Rompe JD, Serafini G et al (2010) US-guided percutaneous treatment of shoulder calcific tendonitis: some clarifications are needed. Radiology 254:990. https://doi.org/10.1148/radiol.091542

    Article  PubMed  Google Scholar 

  24. Filippou G, Adinolfi A, Iagnocco A et al (2016) Ultrasound in the diagnosis of calcium pyrophosphate dihydrate deposition disease. A systematic literature review and a meta-analysis. Osteoarthr Cartil 24:973–981. https://doi.org/10.1016/j.joca.2016.01.136

    Article  CAS  PubMed  Google Scholar 

  25. Sconfienza LM, Serafini G, Sardanelli F (2011) Treatment of calcific tendinitis of the rotator cuff by ultrasound-guided single-needle lavage technique. Am J Roentgenol 197:W366–W366. https://doi.org/10.2214/AJR.10.6295

    Article  Google Scholar 

  26. Rompe JD, Furia J, Maffulli N (2009) Eccentric loading versus eccentric loading plus shock-wave treatment for midportion achilles tendinopathy. Am J Sports Med 37:463–470. https://doi.org/10.1177/0363546508326983

    Article  PubMed  Google Scholar 

  27. Robinson P (2009) Sonography of common tendon injuries. Am J Roentgenol 193:607–618. https://doi.org/10.2214/AJR.09.2808

    Article  Google Scholar 

  28. Di Pietto F, Chianca V, Zappia M, Romano S (2018) Articular and peri-articular hip lesions in soccer players. The importance of imaging in deciding which lesions will need surgery and which can be treated conservatively? Eur J Radiol 105:227–238. https://doi.org/10.1016/j.ejrad.2018.06.012

    Article  PubMed  Google Scholar 

  29. Burke CJ, Adler RS (2016) Ultrasound-Guided Percutaneous Tendon Treatments. Am J Roentgenol 207:495–506. https://doi.org/10.2214/AJR.16.16089

    Article  Google Scholar 

  30. 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. https://doi.org/10.1016/j.ejrad.2017.08.006

    Article  PubMed  Google Scholar 

  31. 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. https://doi.org/10.1016/j.jus.2012.09.006

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Callegari L, Spanò E, Bini A et al (2011) Ultrasound-Guided Injection of a Corticosteroid and Hyaluronic Acid. Drugs R D 11:137–145. https://doi.org/10.2165/11591220-000000000-00000

    Article  PubMed  Google Scholar 

  33. Di Geso L, Filippucci E, Meenagh G et al (2012) CS injection of tenosynovitis in patients with chronic inflammatory arthritis: the role of US. Rheumatology (Oxford) 51:1299–1303

    Article  Google Scholar 

  34. Gutierrez M, Di Matteo A, Rosemffet M et al (2016) Pan-American League against Rheumatisms (PANLAR) Ultrasound Study Group. Short-term efficacy to conventional blind injection versus ultrasound-guided injection of local corticosteroids in tenosynovitis in patients with inflammatory chronic arthritis: a randomized comparative study. Joint Bone Spine 83:161–166

    Article  CAS  Google Scholar 

  35. Orlandi D, Corazza A, Silvestri E et al (2014) Ultrasound-guided procedures around the wrist and hand: how to do. Eur J Radiol 83:1231–1238. https://doi.org/10.1016/J.EJRAD.2014.03.029

    Article  PubMed  Google Scholar 

  36. Bodor M, Flossman T (2009) Ultrasound-guided first annular pulley injection for trigger finger. J Ultrasound Med 28:737–743

    Article  Google Scholar 

  37. 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. https://doi.org/10.1007/s40477-016-0233-2

    Article  PubMed  PubMed Central  Google Scholar 

  38. Greher M, Kirchmair L, Enna B et al (2004) Ultrasound-guided lumbar facet nerve block: accuracy of a new technique confirmed by computed tomography. Anesthesiology 101:1195–1200

    Article  Google Scholar 

  39. Chianca V, Albano D, Messina C et al (2017) Diffusion tensor imaging in the musculoskeletal and peripheral nerve systems: from experimental to clinical applications. Eur Radiol Exp 1:12. https://doi.org/10.1186/s41747-017-0018-1

    Article  PubMed  PubMed Central  Google Scholar 

  40. Anderson PA, McCormick PC, Angevine PD (2008) Randomized controlled trials of the treatment of lumbar disk herniation: 1983-2007. J Am Acad Orthop Surg 16:566–573

    Article  Google Scholar 

  41. Tagliafico A, Bignotti B, Rossi F et al (2017) Ultrasound of the Hip Joint, Soft Tissues, and Nerves. Semin Musculoskelet Radiol 21:582–588. https://doi.org/10.1055/s-0037-1606132

    Article  PubMed  Google Scholar 

  42. Patel VB, Wasserman R, Imani F (2015) Interventional therapies for chronic low back pain: a focused review (efficacy and outcomes). Anesthesiol pain Med 5:e29716. https://doi.org/10.5812/aapm.29716

    Article  Google Scholar 

  43. Bhagia SM, Slipman CW, Nirschl M et al (2006) Side effects and complications after percutaneous disc decompression using coblation technology. Am J Phys Med Rehabil 85:6–13

    Article  Google Scholar 

  44. Mattera M, Reginelli A, Bartollino S et al (2018) Imaging of metabolic bone disease. Acta Biomed 89:197–207. https://doi.org/10.23750/abm.v89i1-S.7023

    Article  PubMed  PubMed Central  Google Scholar 

  45. Messina C, Maffi G, Vitale JA et al (2018) Diagnostic imaging of osteoporosis and sarcopenia: a narrative review. Quant Imaging Med Surg 8:86–99. https://doi.org/10.21037/qims.2018.01.01

    Article  PubMed  PubMed Central  Google Scholar 

  46. Bonaccorsi G, Messina C, Cervellati C et al (2018) Fracture risk assessment in postmenopausal women with diabetes: comparison between DeFRA and FRAX tools. Gynecol Endocrinol 34:404–408. https://doi.org/10.1080/09513590.2017.1407308

    Article  PubMed  Google Scholar 

  47. Cazzato RL, Arrigoni F, Boatta E et al (2018) Percutaneous management of bone metastases: state of the art, interventional strategies and joint position statement of the Italian College of MSK Radiology (ICoMSKR) and the Italian College of Interventional Radiology (ICIR). Radiol Med. https://doi.org/10.1007/s11547-018-0938-8

    Article  PubMed  Google Scholar 

  48. Arrigoni F, Bruno F, Zugaro L et al (2018) Developments in the management of bone metastases with interventional radiology. Acta Biomed 89:166–174. https://doi.org/10.23750/abm.v89i1-S.7020

    Article  PubMed  PubMed Central  Google Scholar 

  49. Riggs BL, Melton LJ (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17:505S–511S

    Article  CAS  Google Scholar 

  50. Ruiz Santiago F, Santiago Chinchilla A, Guzmán Álvarez L et al (2014) Comparative review of vertebroplasty and kyphoplasty. World J Radiol 6:329–343. https://doi.org/10.4329/wjr.v6.i6.329

    Article  PubMed  PubMed Central  Google Scholar 

  51. McGraw JK, Cardella J, Barr JD et al (2003) Society of Interventional Radiology quality improvement guidelines for percutaneous vertebroplasty. J Vasc Interv Radiol 14:827–831

    Article  Google Scholar 

  52. Tsoumakidou G, Too CW, Koch G et al (2017) CIRSE Guidelines on Percutaneous Vertebral Augmentation. Cardiovasc Intervent Radiol 40:331–342. https://doi.org/10.1007/s00270-017-1574-8

    Article  PubMed  Google Scholar 

  53. Garnon J, Koch G, Ramamurthy N et al (2017) Percutaneous imaging-guided screw fixation of osteoporotic transverse fractures of the lower sacrum with cement augmentation: report of 2 cases. Cardiovasc Intervent Radiol 40:1105–1111. https://doi.org/10.1007/s00270-017-1633-1

    Article  PubMed  Google Scholar 

  54. Buy X, Cazzato RL, Catena V et al (2017) Techniques de consolidation osseuse guidée par imagerie en oncologie: cimentoplastie et vissage. Bull Cancer 104:423–432. https://doi.org/10.1016/j.bulcan.2016.12.009

    Article  PubMed  Google Scholar 

  55. Marcucci G, Brandi ML (2010) Kyphoplasty and vertebroplasty in the management of osteoporosis with subsequent vertebral compression fractures. Clin Cases Miner Bone Metab 7:51–60

    PubMed  PubMed Central  Google Scholar 

  56. Hargunani R, Le Corroller T, Khashoggi K et al (2011) Percutaneous vertebral augmentation: the status of vertebroplasty and current controversies. Semin Musculoskelet Radiol 15:117–124. https://doi.org/10.1055/s-0031-1275594

    Article  PubMed  Google Scholar 

  57. Ruiz Santiago F, Pérez Abela AL, Almagro Ratia MM (2012) El final de las vertebroplastias. Radiologia 54:532–538. https://doi.org/10.1016/j.rx.2012.02.002

    Article  CAS  PubMed  Google Scholar 

  58. Masala S, Massari F, Fiori R et al (2009) Future directions in percutaneous vertebroplasty. Radiol Med 114:976–983. https://doi.org/10.1007/s11547-009-0418-2

    Article  CAS  PubMed  Google Scholar 

  59. Mauri G, Nicosia L, Sconfienza LM et al (2018) Safety and results of image-guided vertebroplasty with elastomeric polymer material (elastoplasty). Eur Radiol Exp 2:31. https://doi.org/10.1186/s41747-018-0062-5

    Article  PubMed  PubMed Central  Google Scholar 

  60. Cazzato RL (2019) Biomechanical effects of polymethyl-methacrylate osteoplasty with or without Kirschner-wire augmentation on long bone diaphyses undergoing bending stress: implications for percutaneous imaging-guided consolidation in cancer patients. Eur Radiol Exp 3:5. https://doi.org/10.1186/s41747-018-0082-1

    Article  Google Scholar 

  61. Marcia S, Muto M, Hirsch JA et al (2018) What is the role of vertebral augmentation for osteoporotic fractures? A review of the recent literature. Neuroradiology 60:777–783. https://doi.org/10.1007/s00234-018-2042-0

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milano, Italy

    Vito Chianca, Carmelo Messina, Domenico Albano, Angelo Corazza, Santi Rapisarda, Grazia Pozzi & Luca Maria Sconfienza

  2. S.C. Diagnostica per Immagini ed Ecografia Interventistica, Ospedale Evangelico Internazionale, 16121, Genova, Italy

    Davide Orlandi & Enzo Silvestri

  3. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20100, Milano, Italy

    Carmelo Messina & Luca Maria Sconfienza

  4. Department of Interventional Radiology, University Hospital of Strasbourg, 67000, Strasbourg, France

    Roberto Luigi Cazzato

  5. Dipartimento di Radiologia Interventistica, Istituto Europeo di Oncologia IRCCS, 20100, Milano, Italy

    Giovanni Mauri

Authors
  1. Vito Chianca
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Davide Orlandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carmelo Messina
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Domenico Albano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Angelo Corazza
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Santi Rapisarda
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Grazia Pozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Roberto Luigi Cazzato
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Giovanni Mauri
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Enzo Silvestri
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Luca Maria Sconfienza
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luca Maria Sconfienza.

Ethics declarations

Conflict of interest

Authors have no conflicts of interest to disclose.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chianca, V., Orlandi, D., Messina, C. et al. Interventional therapeutic procedures to treat degenerative and inflammatory musculoskeletal conditions: state of the art. Radiol med 124, 1112–1120 (2019). https://doi.org/10.1007/s11547-019-01018-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-019-01018-8

Keywords

Search

Navigation