Implementation and role of modern musculoskeletal imaging in rheumatological practice in member countries of EULAR

Abstract

ObjectivesTo document the current training, implementation and role of modern musculoskeletal imaging techniques: ultrasound, magnetic resonance imaging, computed tomography and positron emission tomography, among rheumatologists in the member countries of the EULAR.MethodsEnglish-language questionnaires for each imaging modality developed by a EULAR task force were sent out to national and international scientific societies as well as imaging experts in the given modalities involved in research and/or training. The surveys were distributed via an online survey tool (SurveyMonkey). Simple descriptive and summary statistics were calculated from the responses.ResultsMore than 90% of ultrasound (US) experts reported the availability of a US unit in their department. Suspicion of rheumatoid arthritis and spondyloarthritides were the main clinical indications for performing US for diagnostic purposes. Suspicion of sacroiliitis and degenerative spine disease were the most common indications to perform magnetic resonance imaging (MRI) or computed tomography (CT) for diagnostic purposes, while positron emission tomography was mainly performed to diagnose large vessel vasculitis and to investigate fever of unknown origin. The reported percentage of rheumatologists performing US was highly variable, ranging from more than 80% in 6% of countries to less than 10% in 15% of countries. The majority of experts (77%) reported that their national rheumatology societies organise musculoskeletal US courses, while courses in MRI or CT organised by the national rheumatology societies were less commonly reported (29% and 8%, respectively).ConclusionsRheumatologists in Europe utilise modern imaging techniques; however, access to the techniques and training offered is varied.

EULAR recommendations for the reporting of ultrasound studies in rheumatic and musculoskeletal diseases (RMDs)

“…Word count [2,958/3,000] Ultrasound is an imaging technique widely used in patients with rheumatic and musculoskeletal diseases (RMDs) to detect signs of inflammation and destructive changes. [1] Despite an increased use in clinical practice facilitated by major technical advances in the resolution of soft tissue contrast (Bmode or grey-scale (GS)) and of vascular perfusion (Doppler techniques), a relatively long learning curve [2] and, until recently, the absence of agreed scoring systems, have hampered its utilisation for research. [3,4] The European League Against Rheumatism (EULAR) and the Outcome Measures in Rheumatology (OMERACT) Ultrasound Working Group have actively worked towards the standardization of the technique by developing educational programmes and by performing several studies evaluating its reliability, validity, and feasibility.…”

A Virtual Reality–Based App to Educate Health Care Professionals and Medical Students About Inflammatory Arthritis: Feasibility Study

“…However, to our knowledge, there is no app currently available that transports 3D imaging of real patients in combination with actual patient data on a technological VR basis. Given the recognized importance of IA imaging for diagnosis, monitoring, and prognosis, such a VR app can be valuable in the future to reliably train key players of the health care system for clinical routine practice and training to improve the care of IA patients [14,26,27].…”

“…Accordingly, there seems to be some concern about musculoskeletal imaging, particularly among health professionals in training [10][11][12]. Moreover, physicians, medical students, and health professionals explicitly state a need for more in-depth training in imaging and its interpretation regarding musculoskeletal disorders [10,[13][14][15].…”

Scottish rheumatology sonography course: five-year experience of delivering a mentorship-model rheumatology ultrasound training programme accredited by the consortium for the accreditation of sonographic education

“…In the past decades, interest in Musculoskeletal Ultrasound (MSUS) within the Rheumatology setting has steadily grown, and access to ultrasound equipment has become more widespread. 1 The emerging evidence base supports using point-of-care ultrasound to improve decision making and disease monitoring. 2,3 However, educational models supporting training in this area are diverse.…”