Recommendations for musculoskeletal ultrasonography by rheumatologists: Setting global standards for best practice by expert consensus
Article first published online: 4 FEB 2005
Copyright © 2005 by the American College of Rheumatology
Arthritis Care & Research
Volume 53, Issue 1, pages 83–92, 15 February 2005
How to Cite
Brown, A. K., O'Connor, P. J., Roberts, T. E., Wakefield, R. J., Karim, Z. and Emery, P. (2005), Recommendations for musculoskeletal ultrasonography by rheumatologists: Setting global standards for best practice by expert consensus. Arthritis & Rheumatism, 53: 83–92. doi: 10.1002/art.20926
- Issue published online: 4 FEB 2005
- Article first published online: 4 FEB 2005
- Manuscript Accepted: 23 JUL 2004
- Manuscript Received: 23 MAR 2004
- Arthritis Research Campaign
- Delphi technique;
- Rheumatology practice
To establish an expert consensus of best practice for rheumatologists performing musculoskeletal ultrasonography (MUS).
A panel of worldwide experts in MUS was identified by literature review, membership of teaching faculty, and peer recommendation. They were invited to take part in a 4-stage Delphi process employing 2 iterative rounds to establish a consensus of specific indications, anatomic areas, and knowledge and skills required by rheumatologists performing MUS.
Experts in MUS were identified (n = 57; 37 radiologists, 20 rheumatologists). Successive rounds of this rigorous Delphi exercise enabled group consensus to be achieved in 30 of the proposed 37 categories comprising 8 of 13 indications (inflammatory arthritis, tendon pathology, effusion, bursitis, monitoring disease activity, monitoring disease progression, guided aspiration, and injection), 8 of 10 anatomic areas (hand, wrist, elbow, shoulder, hip, knee, ankle and heel, and forefoot), and 14 categories of knowledge and skills (physics, anatomy, pathology, equipment, clinical application and relevance, indications and limitations, artifact, machine function and operation, patient and probe position, planes and system of examination, image optimization, dynamic assessment, color Doppler, and power Doppler).
We have produced the first expert-derived, interdisciplinary consensus of recommendations for rheumatologists performing MUS. This represents a significant advance that will not only direct future rheumatology MUS practice, but will facilitate informed educational development. This is an important step towards the introduction of a specific training curriculum and assessment process to ensure competent rheumatologist ultrasonographers.