83 - Development of a Collaborative Rheumatology and Orthopedic Musculoskeletal Ultrasound Training Program

Sunday, November 6, 2011: 9:00 AM-6:00 PM
Hall F2 - Poster Hall (McCormick Place West)
Minna J. Kohler1, John S. Reach1, Janine Evans1, Lawrence D. Weis1, Joseph E. Craft2 and Liana Fraenkel1, 1Yale University School of Medicine, Veterans Affairs Connecticut Healthcare System, New Haven, CT, 2Yale University School of Medicine, New Haven, CT
Presentation Number: 83

Background/Purpose: Interest in musculoskeletal ultrasound (MUS) training by rheumatologists has grown as a tool to facilitate personalized point-of-care diagnostic testing and treatment. Over the past decade, MUS training has been popular in Europe, and there is now increasing demand by American rheumatologists to obtain training. At this time, no formal training curriculum is required in U.S. rheumatology fellowship programs, and lack of MUS-trained rheumatology faculty often impedes the ability for fellows to become proficient in using MUS.

Method: We describe the development and implementation of a novel, collaborative rheumatology/orthopedic MUS training program at a single academic medical center. The program was developed in conjunction with an orthopedist with advanced training in MUS, access to an ultrasound (US) machine, and clinics that provide care for patients with osteoarthritis and soft tissue rheumatism.

Result: The training program consists of 1) weekly, ½ to 1 day faculty-mentored MUS injection clinic, 2) instructional didactic sessions, 3) monthly hands-on didactic practice sessions, and 4) options to participate in a web-based fellows ultrasound training program (USSONAR) and the American College of Rheumatology MUS course for further training in rheumatology-focused MUS applications. In the MUS clinic, rheumatology fellows and orthopedic residents consecutively evaluate patients referred for musculoskeletal pain, willing to seek a corticosteroid injection if clinically indicated. All patients are evaluated by a fellow/resident under direct faculty supervision by our MUS expert. The clinic consists of half hour appointments in which the patient is clinically evaluated and diagnostic US or US-guided injection is performed. Instructional didactic sessions review basic physics principles of US, function of basic controls on an US machine, and methods to optimize an US image. Monthly hands-on didactic training sessions review anatomy and ultrasound scanning protocols. Fellows/residents also practice US needle-guidance training with phantom models. The program additionally supports clinical research projects. To allow adequate mentored, hands-on ultrasound time, two fellows/residents per clinic can be trained over a year.     

Conclusion: Development and implementation of a MUS clinic is feasible with an ultrasound expert, ultrasound machine, and patients who benefit from MUS point-of-care. The collaborative MUS program is beneficial to the education of both rheumatology fellows and orthopedic residents.


Keywords: education, medical and ultrasound

Disclosure: M. J. Kohler, None; J. S. Reach, None; J. Evans, None; L. D. Weis, None; J. E. Craft, None; L. Fraenkel, None.