Rheumatology Advance Access originally published online on September 26, 2006
Rheumatology 2007 46(3):519-522; doi:10.1093/rheumatology/kel327
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Comparison of musculoskeletal ultrasound practices of a rheumatologist and a radiologist
1Department of Rheumatology and 2Department of Radiology, Freeman Hospital, High Heaton, Newcastle-upon-Tyne, NE7 7DN, UK and 3School of Clinical and Medical Sciences (Rheumatology), University of Newcastle-upon-Tyne, Newcastle-upon-Tyne, UK.
Correspondence to: D. Kane, Department of Rheumatology, Adelaide and Meath Hospital (incorporating the National Children's Hospital), Tallaght, Dublin 24, Ireland. E-mail: david.kane{at}amnch.ie
 |
Abstract |
|---|
Objective. There is considerable debate regarding the role of the rheumatologist ultrasonographer and how this development will impact on musculoskeletal ultrasound (MSUS) performed by radiologists. We compared the MSUS practices of a rheumatologist and a radiologist working within the same National Health Service Trust.
Methods. A retrospective review of MSUS reports of consecutive scans performed by a consultant rheumatologist with a special interest in MSUS and a consultant musculoskeletal radiologist. Reports were analysed for referring specialities, indications for MSUS, joint regions scanned, MSUS findings, frequency with which patients were referred for injection and how often injection was performed.
Results. A total of 170 patients were referred to the rheumatologist for MSUS of 282 joint regions (91% referred by rheumatologists). Of those, 84 (49%) patients had MSUS examination of more than one joint region, with up to five regions scanned per sitting. One hundred patients were referred to the radiologist for MSUS of 111 joint regions (49% referred by orthopaedic surgeons). The most frequently requested primary indication for MSUS performed by the rheumatologist was detection of synovitis [74 (44%) patients] while MSUS performed by the radiologist was most frequently for assessment for major structural changes [44 (44%) patients]. The rheumatologist performed MSUS-guided injection in 59 of 170 (35%) patients scanned and the radiologist in 13 of 100 (13%).
Conclusion. MSUS performed by the rheumatologist was predominantly requested by rheumatologists to aid diagnosis of synovial and tendon inflammation and to guide injections, while MSUS performed by the radiologist was predominantly requested by orthopaedic surgeons to aid diagnosis of structural pathology. Curriculums in MSUS designed for rheumatologists may need to place appropriate emphasis on the identification of synovial and tendon inflammation, and injection guidance.
KEY WORDS: Musculoskeletal, Ultrasound, Rheumatologist, Radiologist, Injection
Submitted 6 July 2006;
revised version accepted 15 August 2006.
CiteULike 
Connotea 
Del.icio.us What's this?