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Clinical implementation of musculoskeletal ultrasound in rheumatology in Austria

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Abstract

The aim of the study is to assess the clinical implementation of musculoskeletal ultrasound (MSUS) in rheumatology in Austria. A survey was conducted among Austrian rheumatologists and physicians of other specialties with a focus on rheumatology. The questionnaire was designed by the members of the Austrian Radiology–Rheumatology Initiative for Musculoskeletal UltraSound including the following items: demographics, access to MSUS and MSUS training, application of MSUS to support diagnosis, monitoring and treatment decisions, and obstacles for the routine performance of MSUS. Eighty-eight (21.9 %) out of the 402 surveyed physicians responded. No access to MSUS and/or inadequate training in the technique was more commonly reported by senior (>50 years; 64.3 and 67.7 %, respectively) than by younger physicians (16.7 %, p = 0.01 and 18.5 %, p < 0.001, respectively). The lowest availability of sonography was found among senior rheumatologists (25.0 %, p = 0.001 compared to the total group). MSUS is routinely used for diagnosis and/or monitoring purposes by 12.5 % of physicians and 20.5 % perform sonography in clinically unclear cases. A limited number of physicians apply the method to support treatment decisions and/or to evaluate treatment success. The most important obstacles for routine application of MSUS in rheumatology are limited access to ultrasound machines, lack of training/education in the technique, and time constraints in daily routine. Low access to high-end ultrasound devices, lack of training, and time constraints may explain the low appreciation of MSUS among Austrian physicians evaluating patients with rheumatic diseases.

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References

  1. Schirmer M, Duftner C, Schmidt WA, Dejaco C (2011) Ultrasonography in inflammatory rheumatic disease: an overview. Nat Rev Rheumatol 7:479–488

    Article  PubMed  Google Scholar 

  2. Dejaco C, Duftner C, Schirmer M (2012) Expectations of rheumatologists on imaging results. Radiologe 52:110–115

    Article  CAS  PubMed  Google Scholar 

  3. Mandl P, Balint PV, Brault Y, Backhaus M, D’Agostino MA, Grassi W, van der Heijde D, de Miguel E, Wakefield RJ, Logeart I, Dougados M (2012) Metrologic properties of ultrasound versus clinical evaluation of synovitis in rheumatoid arthritis: results of a multicenter, randomized study. Arthritis Rheum 64:1272–1282

    Article  CAS  PubMed  Google Scholar 

  4. Scire CA, Montecucco C, Codullo V, Epis O, Todoerti M, Caporali R (2009) Ultrasonographic evaluation of joint involvement in early rheumatoid arthritis in clinical remission: power Doppler signal predicts short-term relapse. Rheumatology 48:1092–1097

    Article  CAS  PubMed  Google Scholar 

  5. Saleem B, Brown AK, Quinn M, Karim Z, Hensor EM, Conaghan P, Peterfy C, Wakefield RJ, Emery P (2012) Can flare be predicted in DMARD treated RA patients in remission, and is it important? A cohort study. Ann Rheum Dis 71:1316–1321

    Article  PubMed  Google Scholar 

  6. Brown AK, Quinn MA, Karim Z, Conaghan PG, Peterfy CG, Hensor E, Wakefield RJ, O’Connor PJ, Emery P (2006) Presence of significant synovitis in rheumatoid arthritis patients with disease-modifying antirheumatic drug-induced clinical remission: evidence from an imaging study may explain structural progression. Arthritis Rheum 54:3761–3773

    Article  CAS  PubMed  Google Scholar 

  7. Naredo E, D’Agostino MA, Conaghan PG, Backhaus M, Balint P, Bruyn GA, Filippucci E, Grassi W, Hammer HB, Iagnocco A, Kane D, Koski JM, Szkudlarek M, Terslev L, Wakefield RJ, Ziswiler HR, Schmidt WA (2010) Current state of musculoskeletal ultrasound training and implementation in Europe: results of a survey of experts and scientific societies. Rheumatology 49:2438–2443

    Article  PubMed  Google Scholar 

  8. Wakefield RJ, D’Agostino MA, Naredo E, Buch MH, Iagnocco A, Terslev L, Ostergaard M, Backhaus M, Grassi W, Dougados M, Burmester GR, Saleem B, de Miguel E, Estrach C, Ikeda K, Gutierrez M, Thompson R, Balint P, Emery P (2012) After treat-to-target: can a targeted ultrasound initiative improve RA outcomes? Ann Rheum Dis 71:799–803

    Article  PubMed  Google Scholar 

  9. Dejaco C, Duftner C, Machold K, Graninger W, Schirmer M (2011) Referat Bildgebung der ÖGR, Schwerpunkt muskuloskelettale Sonographie in der Rheumatologie, geplante Aktivitäten. Austrian Society of Rheumatology. http://www.rheumatologie.at/aerzteinformation/arbeitsbereiche/referat_bildgebung/index.php

  10. Wakefield RJ, Goh E, Conaghan PG, Karim Z, Emery P (2003) Musculoskeletal ultrasonography in Europe: results of a rheumatologist-based survey at a EULAR meeting. Rheumatology 42:1251–1253

    Article  CAS  PubMed  Google Scholar 

  11. Larche MJ, McDonald-Blumer H, Bruns A, Roth J, Khy V, de Brum-Fernandes AJ, Wakefield RJ, Brown AK, Bykerk V (2011) Utility and feasibility of musculoskeletal ultrasonography (MSK US) in rheumatology practice in Canada: needs assessment. Clin Rheumatol 30:1277–1283

    Article  PubMed  Google Scholar 

  12. Takase K, Ohno S, Ideguchi H, Takeno M, Shirai A, Ishigatsubo Y (2010) Use of musculoskeletal ultrasound in Japan: a survey of practicing rheumatologists. Mod Rheumatol 20:376–380

    Article  PubMed  Google Scholar 

  13. Tamas MM, Fodor D, Rednic N, Rednic S (2011) Musculoskeletal ultrasonography in Romania—results from a specific questionnaire. Med Ultrason 13:10–14

    PubMed  Google Scholar 

  14. Cunnington J, Platt P, Raftery G, Kane D (2007) Attitudes of United Kingdom rheumatologists to musculoskeletal ultrasound practice and training. Ann Rheum Dis 66:1381–1383

    Article  PubMed Central  PubMed  Google Scholar 

  15. Samuels J, Abramson SB, Kaeley GS (2010) The use of musculoskeletal ultrasound by rheumatologists in the United States. Bull NYU Hosp Jt Dis 68:292–298

    PubMed  Google Scholar 

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Acknowledgments

Meetings of ARRIMUS and the performance of this survey by an independent company (Schütz Marketing service, Vienna, Austria) were supported by AbbVie. C.De. and C.Du received honoraria for the preparation of this manuscript.

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Correspondence to Christian Dejaco.

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Duftner, C., Schüller-Weidekamm, C., Mandl, P. et al. Clinical implementation of musculoskeletal ultrasound in rheumatology in Austria. Rheumatol Int 34, 1111–1115 (2014). https://doi.org/10.1007/s00296-013-2863-4

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  • DOI: https://doi.org/10.1007/s00296-013-2863-4

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