Dr. Kissin has received consultant fees, speaking fees, and/or honoraia (less than $10,000 each) from SonoSite and Amgen-Wyeth.
Self-directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States
Version of Record online: 8 JAN 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis Care & Research
Volume 62, Issue 2, pages 155–160, February 2010
How to Cite
Kissin, E. Y., Nishio, J., Yang, M., Backhaus, M., Balint, P. V., Bruyn, G. A. W., Craig-Muller, J., D'Agostino, M. A., Feoktistov, A., Goyal, J., Iagnocco, A., Ike, R. W., Moller, I., Naredo, E., Pineda, C., Schmidt, W. A., Swen, N., Tabechian, D., Wakefield, R. J., Wells, A. F. and Kaeley, G. S. (2010), Self-directed learning of basic musculoskeletal ultrasound among rheumatologists in the United States. Arthritis Care Res, 62: 155–160. doi: 10.1002/acr.20063
- Issue online: 26 JAN 2010
- Version of Record online: 8 JAN 2010
- Accepted manuscript online: 8 JAN 2010 12:00AM EST
- Manuscript Accepted: 21 SEP 2009
- Manuscript Received: 1 FEB 2009
Because musculoskeletal ultrasound (MSUS) is highly user dependent, we aimed to establish whether non-mentored learning of MSUS is sufficient to achieve the same level of diagnostic accuracy and scanning reliability as has been achieved by rheumatologists recognized as international experts in MSUS.
A group of 8 rheumatologists with more experience in MSUS and 8 rheumatologists with less experience in MSUS participated in an MSUS exercise to assess patients with musculoskeletal abnormalities commonly seen in a rheumatology practice. Patients' established diagnoses were obtained from chart review (gout, osteoarthritis, rotator cuff syndrome, rheumatoid arthritis, and seronegative arthritis). Two examining groups were formed, each composed of 4 less experienced and 4 more experienced examiners. Each group scanned 1 predefined body region (hand, wrist, elbow, shoulder, knee, or ankle) in each of 8 patients, blinded to medical history and physical examination. Structural abnormalities were noted with dichotomous answers, and an open-ended answer was used for the final diagnosis.
Less experienced and more experienced examiners achieved the same diagnostic accuracy (US-established diagnosis versus chart review diagnosis). The interrater reliability for tissue pathology was slightly higher for more experienced versus less experienced examiners (κ = 0.43 versus κ = 0.34; P = 0.001).
Non-mentored training in MSUS can lead to the achievement of diagnostic accuracy in MSUS comparable to that achieved by highly experienced international experts. Reliability may increase slightly with additional experience. Further study is needed to determine the minimal training requirement to achieve proficiency in MSUS.