Musculoskeletal Interventions in the era of COVID-19: Current Scenario and Review of Literature Regarding Procedures, Practices, and Precautions

Given the current severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic we find ourselves in, the availability of clinically relevant and reliable information regarding any diagnostic test and therapy for clinicians and patients is of utmost importance. As SARS-CoV-2 is a new virus, there are no long-term data regarding the effect of therapeutic musculoskeletal interventions on patients infected with it. Some reports published in recent literature state that corticosteroids may exacerbate symptoms in coronavirus disease 2019 (COVID-19) while other conflicting ones show improvement in patient symptoms; however, these are based on systemic corticosteroids and not locally injected ones. A few musculoskeletal, pain management, and orthopedic societies around the world have recently published their guidelines for performing these interventions. ASRA- ESRA guidelines recommend using ultrasound guidance to perform musculoskeletal and pain interventions over “blind” non-image-guided procedures to reduce local anesthetic systemic toxicity. This article aims to review the current literature for musculoskeletal interventional practices with regard to COVID-19 and also detail the various precautions which musculoskeletal interventional radiologists can take to protect themselves and their patients from SARS-CoV-2 as per current guidelines.