Rheumatology 2003; 42: 1109
© 2003 British Society for Rheumatology
Letters to the Editor |
Reply to: Rheumatological ultrasound
Sports & Exercise Medicine Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge and
1 Box 219, Department of Radiology, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK
We thank Wakefield et al. for their interest in our recent letter and editorial [1, 2] and we welcome the news that the ARC have recently funded a fellowship for one of their co-authors to develop a validated system for training the non-radiologist in musculoskeletal ultrasound. This is exactly the type of initiative that we were suggesting in our paper.
The issues that Wakefield et al. raise in relation to the rich European experience in musculoskeletal ultrasound training for non-radiologists, the lack of a standardized exit examination, the need for a logbook and the lack of agreement about the number of examinations needed to acquire proficiency mirror our own views, as expressed in the editorial. In addition, we are pleased to see that papers are starting to be published that provide data to quantify the impact of ultrasound in the evaluation of rheumatology patients. Our only concern is that creating a training scheme based in an environment where there are five musculoskeletal radiologists and three rheumatologists trained in musculoskeletal ultrasound will limit the number of potential training centres, and this will not be sufficient to train the number of rheumatologists who need to acquire musculoskeletal ultrasound skills.
The long-term challenge and vision must be to create a decentralized training and accreditation programme based on agreed standards of performance, with the various Royal Colleges working together. Furthermore, the issue of musculoskeletal ultrasonography being performed by non-radiologists is potentially of interest not only to rheumatologists but also to other groups of health professionals, including orthopaedic surgeons, general practitioners, sports physicians, physiotherapists and existing sonographers.
Notes
Correspondence to: C. A. Speed. E-mail: cas50{at}medschl.cam.ac.uk 
References
- Wakefield RJ, Brown A, O'Connor P et al. Rheumatology ultrasound. Rheumatology 2002;42:100.
- Speed CA, Bearcroft PWP. Musculoskeletal sonography by rheumatologists: the challenges. Rheumatology 2002;41:241–2.
[Free Full Text] - Speed CA, Bearcroft PWP. Training in musculoskeletal sonography: a report from the first BSR course. Rheumatology 2002;41:346.
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