1
|
Practical ultrasound workshops to teach medical students basic concepts of ultrasound semiology. RADIOLOGIA 2020. [DOI: 10.1016/j.rxeng.2020.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
2
|
Guillén Astete C, Rodrigo González S, Alfonso Pérez D, Luque Alarcón M, Penedo Alonso R, Estévez Rueda MJ. Quality Health Care in Acute Shoulder Pain: What Is the Contribution of Musculoskeletal Ultrasound? REUMATOLOGIA CLINICA 2020; 16:290-293. [PMID: 30528514 DOI: 10.1016/j.reuma.2018.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/04/2018] [Accepted: 08/29/2018] [Indexed: 06/09/2023]
Abstract
For the purpose of assessing the impact of ultrasound in patients with acute shoulder pain, we conducted an analysis of quality health care indicators: need for reevaluation of the pain, rate of referral to specialized medicine and length of time in the emergency department. We reviewed the 1,433 records of patients attended to between 2015 and 2016. Thirty days after the first examination, 90 patients (10.1%) had returned to the control group (56 through the emergency department and 34 because of the), whereas, in the ultrasound (US) group, 14 (2.5%) had returned at least once (12 through the emergency department and 2 because of the PCC) (P<.001). The rate of referral to specialized medicine in the control group was 36.5%, whereas in the US group it was 6.21% (P<.0001). The average length of stay was 94.5 (standard deviation [SD] 34.3) minutes in the control group and 105.4 (SD 40.1) minutes in the US group (P<.0001). Our results suggest that the practice of shoulder ultrasound improves health care quality in these patients, at the cost of a slight increase in health care time.
Collapse
|
3
|
Paternain Nuin A, Malmierca Ordoqui P, Igual Rouilleault AC, Soriano Aguadero I, Pueyo Villoslada JC. Practical ultrasound workshops to teach medical students basic concepts of ultrasound semiology. RADIOLOGIA 2020; 62:306-312. [PMID: 32035725 DOI: 10.1016/j.rx.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 12/10/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of practical ultrasound workshops for the acquisition and consolidation of conceptual learning about the basic physics and semiology of ultrasonography aimed at third-year medical school students doing the physical examination module of their studies. MATERIAL AND METHODS We carried out practical ultrasound workshops with two groups of 177 and 175 students in two consecutive academic years. All students had taken a class in basic radiology in the previous year. Students examined each other with ultrasonography under instructors' supervision in a two-hour session. Before and after the workshop, students did a seven-question multiple-choice test about basic semiology and answered two questions evaluating their degree of confidence in interpreting ultrasonographic images and handling the ultrasound scanner on a scale from 1 to 10. RESULTS No significant differences were found between the scores obtained in the two groups. Overall, the mean score on the multiple-choice test improved from 59.71% on the initial assessment to 88.29% on the post-workshop assessment (p <0.01). Confidence in interpreting images improved from 3.39/10 to 6.28/10 (p <0.01), and confidence in handling the equipment improved from 3.73/10 to 6.51/10 (p <0.01). CONCLUSION Practical workshops were useful for learning basic concepts about ultrasound imaging, allowing students to significantly improve their scores on the multiple-choice test. Students had a low level of confidence in their ability to interpret ultrasound images and handle the equipment before starting the workshop, but their confidence improved significantly after completing the workshop.
Collapse
Affiliation(s)
- A Paternain Nuin
- Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
| | - P Malmierca Ordoqui
- Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | | | - I Soriano Aguadero
- Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - J C Pueyo Villoslada
- Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, Navarra, España
| |
Collapse
|
4
|
Mandl P, Ciechomska A, Terslev L, Baraliakos X, Conaghan PG, D'Agostino MA, Iagnocco A, van der Laken CJ, Ostergaard M, Naredo E. Implementation and role of modern musculoskeletal imaging in rheumatological practice in member countries of EULAR. RMD Open 2019; 5:e000950. [PMID: 31321076 PMCID: PMC6606074 DOI: 10.1136/rmdopen-2019-000950] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/11/2019] [Accepted: 05/15/2019] [Indexed: 11/04/2022] Open
Abstract
Objectives To 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. Methods English-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. Results More 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). Conclusions Rheumatologists in Europe utilise modern imaging techniques; however, access to the techniques and training offered is varied.
Collapse
Affiliation(s)
- Peter Mandl
- Department of Rheumatology, Medical University Vienna, Vienna, Austria
| | - Anna Ciechomska
- Department of Rheumatology, Wishaw General Hospital, Wishaw, UK
| | - L Terslev
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Glostrup, Copenhagen, Denmark
| | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet Sankt Josefs-Krankenhaus, Herne, Nordrhein-Westfalen, Germany.,Rheumatology Department, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany
| | - P G Conaghan
- Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Maria Antonietta D'Agostino
- Rheumatology, Ambroise Paré Hospital, APHP, Université Versailles-Saint-Quentin en Yvelines, Boulogne-Billancourt, France
| | - Annamaria Iagnocco
- Scienze Cliniche e Biologiche, Università degli Studi di Torino, Rome, Italy
| | - Conny J van der Laken
- Department of Rheumatology, VU University Medical Center, Amsterdam, Noord-Holland, The Netherlands
| | - Mikkel Ostergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, Denmark
| | - E Naredo
- Department of Rheumatology, Joint and Bone Research Unit, Hospital Universitario Fundación Jiménez Díaz and Autónoma University, Madrid, Spain
| |
Collapse
|
5
|
Andréu JL, Silva-Fernández L, Galla T. Progress of the attractiveness of Rheumatology among medical speciality training candidates (MIR) in Spain. REUMATOLOGIA CLINICA 2018; 14:150-154. [PMID: 27988135 DOI: 10.1016/j.reuma.2016.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/18/2016] [Accepted: 11/03/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To describe the progress of the attractiveness of rheumatology at successive MIR calls, from 1983 to 2014. METHODS Candidates in the Spanish training system for medical doctors choose their specialties sequentially, ordered by their ranking in the qualifying exam (MIR). The highest, median and lowest rank of candidates choosing rheumatology training positions in every MIR call from 1983 to 2014 was requested from the Department of Management of Specialized Medical Training (General Department of Professional Regulation; Spanish Ministry of Health). To compare, the same data was requested for other specialties. In order to define and analyze the attractiveness of each specialty we introduce an 'index of attractiveness', based on the normalized difference of the actual median rank reported for each year and the average median obtained in 1000 simulations in which candidates choose specialties at random. RESULTS Regarding the median of the election of rheumatology, the range went from 244th in 1983 to 3394th in 2008, showing a progressive increase over the years in absolute figures. A mathematical simulation allowed quantifying the difference between the observed median and what would have happened if specialties had been chosen by pure chance. Results show a tendency to recover the attractiveness of rheumatology in recent years. CONCLUSIONS After a sharp decline in the attractiveness of rheumatology during the last years of the 20th century, there seems to be a recovery.
Collapse
Affiliation(s)
- José Luis Andréu
- Servicio de Reumatología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, España.
| | - Lucía Silva-Fernández
- Sección de Reumatología, Complexo Hospitalario Universitario de Ferrol, Ferrol, A Coruña, España
| | - Tobias Galla
- Theoretical Physics, School of Physics and Astronomy, The University of Manchester, Mánchester, Reino Unido
| |
Collapse
|
6
|
Mandl P, Baranauskaite A, Damjanov N, Hojnik M, Kurucz R, Nagy O, Nemec P, Niedermayer D, Perić P, Petranova T, Pille A, Rednic S, Vlad V, Zlnay M, Balint PV. Musculoskeletal ultrasonography in routine rheumatology practice: data from Central and Eastern European countries. Rheumatol Int 2016; 36:845-54. [PMID: 26923691 PMCID: PMC4873522 DOI: 10.1007/s00296-016-3442-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/10/2016] [Indexed: 12/01/2022]
Abstract
The main aim was to gain structured insight into the use of musculoskeletal ultrasonography (MSUS) in routine rheumatology practices in Central and Eastern European (CEE) countries. In a cross-sectional, observational, international, multicenter survey, a questionnaire was sent to investigational sites in CEE countries. Data on all subsequent routine MSUS examinations, site characteristics, MSUS equipment, and investigators were collected over 6 months or up to 100 examinations per center. A total of 95 physicians at 44 sites in 9 countries provided information on a total of 2810 MSUS examinations. The most frequent diagnoses were rheumatoid arthritis (RA) and spondyloarthritis (34.8 and 14.9 % of cases, respectively). Mean number of joints examined was 6.8. MSUS was most frequently performed for diagnostic purposes (58 %), particularly in patients with undifferentiated arthritis, suspected soft tissue disorders, or osteoarthritis (73.0–85.3 %). In RA patients, 56.3 % of examinations were conducted to monitor disease activity. Nearly all investigations (99 %) had clinical implications, while the results of 78.6 % of examinations (51.6–99.0 %) were deemed useful for patient education. This first standardized multicountry survey performed in CEEs provided a structured documentation of the routine MSUS use in participating countries. The majority of MSUS examinations were performed for diagnostic purposes, whereas one-third was conducted to monitor disease activity in RA. A majority of examinations had an impact on clinical decision making and were also found to be useful for patient education.
Collapse
Affiliation(s)
- Peter Mandl
- Division of Rheumatology, 3rd Department of Internal Medicine, Medical University of Vienna, 18-20 Währinger Gürtel, Vienna, Austria. .,3rd Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary.
| | - Asta Baranauskaite
- Department of Rheumatology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nemanja Damjanov
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia
| | - Maja Hojnik
- Global Medical Affairs Rheumatology, AbbVie, Ljubljana, Slovenia
| | - Reka Kurucz
- 3rd Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | | | - Petr Nemec
- Department of Rheumatology, St. Anne's University Hospital, Brno, Czech Republic
| | - Dora Niedermayer
- 3rd Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | - Porin Perić
- Department of Rheumatology, Clinical Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia
| | - Tzvetanka Petranova
- Department of Rheumatology, UMHAT St.Iv.Rilsky, Medical University, Sofia, Bulgaria
| | | | - Simona Rednic
- Department of Rheumatology, Clinical County Emergency Hospital, Cluj-Napoca, Romania
| | - Violeta Vlad
- Department of Rheumatology, Sf. Maria Clinical Hospital, Bucharest, Romania
| | - Martin Zlnay
- Department of Rheumatology, National Institute of Rheumatic Diseases, Piestany, Slovak Republic
| | - Peter V Balint
- 3rd Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| |
Collapse
|
7
|
|
8
|
de Miguel E, Andreu JL, Naredo E, Möller I. La ecografía en reumatología: dónde estamos y hacia dónde nos dirigimos. ACTA ACUST UNITED AC 2014; 10:6-9. [DOI: 10.1016/j.reuma.2013.04.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 03/29/2013] [Accepted: 04/03/2013] [Indexed: 11/26/2022]
|
9
|
Mata Arnaiz MC, de Miguel Mendieta E. Usefulness of ultrasonography in the assessment of peripheral enthesis in spondyloarthritis. ACTA ACUST UNITED AC 2013; 10:113-9. [PMID: 24360900 DOI: 10.1016/j.reuma.2013.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 11/11/2013] [Indexed: 12/01/2022]
Abstract
Enthesitis is one of the characteristic etiopathogenic manifestations of spondyloarthritis. However, in clinical practice, its presence often goes unnoticed because of the lack of precision and sensitivity of physical examination to detect it. Viable, valid and reliable imaging tests are needed for early diagnosis, as well as a good sensitivity to change to monitor therapeutic response. In this paper we review the most relevant aspects of current knowledge of the enthesis and discusses the validity of ultrasound for assessing enthesitis in spondyloarthritis and its sensitivity to change to monitor therapeutic response.
Collapse
|