Recommended Musculoskeletal and Sports Ultrasound Terminology: A Delphi‐Based Consensus Statement

Abstract

Objectives-The current lack of agreement regarding standardized terminology in musculoskeletal and sports ultrasound presents challenges in education, clinical practice, and research. This consensus was developed to provide a reference to improve clarity and consistency in communication.Methods-A multidisciplinary expert panel was convened consisting of 18 members representing multiple specialty societies identified as key stakeholders in musculoskeletal and sports ultrasound. A Delphi process was used to reach consensus which was defined as group level agreement >80%.Results-Content was organized into seven general topics including: 1) General Definitions, 2) Equipment and Transducer Manipulation, 3) Anatomic and Descriptive Terminology, 4) Pathology, 5) Procedural Terminology, 6) Image Labeling, and 7) Documentation. Terms and definitions which reached consensus agreement are presented herein.Conclusions-The historic use of multiple similar terms in the absence of precise definitions has led to confusion when conveying information between colleagues, patients, and third-party payers. This multidisciplinary expert consensus addresses multiple areas of variability in diagnostic ultrasound imaging and ultrasound-guided procedures related to musculoskeletal and sports medicine.

Neuromuscular ultrasound standardized scanning techniques and protocols: Expert panel recommendations

“…The lack of consensus on some aspects in each protocol is either related to personal technical preference among the experts, lack of reference values for certain measurements, or the need of further validation and consensus (Table S7). Similar to our results, in a recent consensus study addressing musculoskeletal and sports ultrasound terminology, the panel did not reach consensus on orientation of the image relative to the target structure and the directional orientation of the probe 30 . Although the experts did not agree on the length of the nerve that should be scanned in focal mononeuropathies, the 70% level of consensus on scanning the nerve the nerve at least 5–10 cm proximal and distal to the pathology site implies the importance of scanning beyond the pathology site to some degree.…”

“…Similar to our results, in a recent consensus study addressing musculoskeletal and sports ultrasound terminology, the panel did not reach consensus on orientation of the image relative to the target structure and the directional orientation of the probe. 30 Although the experts did not agree on the length of the nerve that should be scanned in focal mononeuropathies, the 70% level of consensus on scanning the nerve the nerve at least 5-10 cm proximal and distal to the pathology site implies the importance of scanning beyond the pathology site to some degree. Furthermore, many experts have recommended scanning the entire nerve course if there is concern regarding missing unexpected pathology.…”

Standardised lesion segmentation for imaging biomarker quantitation: a consensus recommendation from ESR and EORTC

“…Panels included multiple stakeholders, who were healthcare professionals in 95% of cases [24]. More recently, Delphi studies involving imaging have convened multidisciplinary expert panels of 18-50 relevant stakeholders [27][28][29][30].…”

A Retrospective Case Series Study on a Minimally-Invasive Ultrasound-Guided First Dorsal Compartment Release Technique for Refractory De Quervain Tenosynovitis

“…The symptoms had to have been present for at least 3 mos and had failed conservative management including activity modification, oral nonsteroidal anti-inflammatory medication, corticosteroid injection into the tendon sheath, and either a physician-led home exercise program or formal physical therapy. At the time of the procedure, tenosynovitis was characterized utilizing ultrasound visualization showing distention of a tendon sheath from fluid of variable echogenicity with or without synovial hypertrophy, 16 hyperemia visible on Doppler imaging, thickening of the extensor retinaculum overlying the first dorsal compartment, and reproduction of pain with sonopalpation 17 . There was a minimum follow-up time of 1 yr.…”