Learning curve of office-based ultrasonography for rotator cuff tendons tears

Ok, Ji-Hoon; Kim, Yang-Soo; Kim, Jung-Man; Yoo, Taewook

doi:10.1007/s00167-012-2105-4

Cited by 32 publications

(37 citation statements)

References 20 publications

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“…This reproducibility is also supported by other series [6] and evaluated in recent studies such as in Seijas et al [7] . Studies on interobserver variability with ultrasound in tendons have shown a very high concordance rate, specifically in knee a very high correlation rate has been shown [8] .…”

Section: International Journal Of Orthopaedicssupporting

confidence: 80%

Direct Measurements of the Tendon

Seijas

Lorente

Ares

et al. 2017

International Journal of Orthopaedics

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Section: International Journal Of Orthopaedicssupporting

confidence: 80%

Direct Measurements of the Tendon

Seijas

Lorente

Ares

et al. 2017

International Journal of Orthopaedics

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“…The learning curve in musculoskeletal US was found to be an important aspect in the time of gaining skills in beginner ultrasonographers [33][34][35]. The 2 beginner members of team B rapidly achieved knowledge about MCP examination.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography of the metacarpophalangeal joints in healthy subjects using an 18 MHz transducer.

Fodor

Felea²,

Popescu³

et al. 2015

Med Ultrason

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Aim: To evaluate the metacarpophalangeal (MCP) joints (MCP2 and 5) in healthy subjects by ultrasonography (US) using a high frequency transducer (18 MHz) and to verify the interobserver agreement. Material and methods: We enrolled 50 healthy volunteers (37 women, age between 30-58 years, mean age 41.7 years, divided into 3 groups according to age: 30-39, 40-49, and 50-58 years). The subjects were successively evaluated by 4 rheumatologists: 2 experienced (team A) and 2 beginners (team B) in US. Seven dorsal and palmar longitudinal scanning positions and a supplementary scan for MCP cartilage were performed. The bone surface (erosions, osteophytes), the intra-articular content (synovial thickening and vascularization, 4 grade scale), and the aspect of the metacarpal head cartilage were analyzed. The anterior palmar recess was measured. The time for examination was recorded. Results: Erosions were detected in 7% of joints by team A and 2% by team B (p<0.05, kappa agreement 0.567) in subjects over 40 years. The agreement by team A in the detection of the erosions was very good (kappa value 0.83). A moderate positive correlation was obtained between the presence of erosions and age (r= 0.401, p=0.004). Osteophytes were identified only on the dorsal scan in subjects over 50 years (in 3.5% of joints team A, 1.5% team B, p>0.05, kappa value 0.421). No grade 1 synovitis was observed by team A but 4 joints with grade 1 synovitis were identified by team B (p<0.05) from the dorsal scan. The dimensions of the palmar recess had large distribution (MCP 2 between 0.55-1.3 mm; MCP 5 between 0.6-1.2 mm). No statistical significant differences were obtained when comparing the dimensions of the two hands or the values obtained in agegroups (all p>0.05). No statistical significant correlations were obtained between the dimensions of palmar recess and the body mass index or dominant hand (all p>0.05). No pathological findings were found in the examination of the metacarpal head cartilage. Power Doppler investigation found the presence of grade 1 signal in 2.5% joints by team A and 1.5% by team B (p>0.05) only in the dorsal scans. The mean time for examination was 7.8±1.74 min in team A and 13.78±2.96 min in team B (p<0.05). Conclusions: In healthy subjects pathological findings are occasionally encountered, especially erosions and osteophytes. Using an 18 MHz transducer the aspect of grade 1 synovitis was not encountered in healthy non-inflammatory MCP joints. There is a permanent need for standardized training and examination in musculoskeletal US.

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“…Other related studies reporting on US evaluations of musculoskeletal conditions by physicians who were previously inexperienced with the use of US have included instruction ranging from 5 hours to 7 days; however, in contrast, we provided only 30 minutes of instruction . This discrepancy may be explained in part by the heterogeneous populations participating in the studies.…”

Section: Discussionmentioning

confidence: 96%

“…To our knowledge, an investigation of the learning curve for US performance by hand surgeons has not previously been explored in the literature. However, there have been some studies that reported on the learning curve for the use of US in evaluations of rotator cuff disorders by orthopedic surgeons who were previously inexperienced with US . Alavekios et al reported on the results of 200 consecutive shoulder US examinations conducted by each of 2 orthopedic surgeons who were previously inexperienced with the use of US and who received 3 days’ worth of instruction at an instructional course.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Acquisition of Ultrasound Proficiency in Hand Surgery Fellows

Zumsteg

Ina

Merrell

2019

J of Ultrasound Medicine

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Objectives To evaluate hand surgery fellow ultrasound (US) evaluations and performance of clinically relevant tasks after brief instruction. Methods Six hand surgery fellows completed an US assessment and a survey on US use before and 1 month after a 30‐minute US course. Results The time to obtain an adequate image decreased from 4 minutes 42 seconds (4:42; range, 3:57–7:55) to 0:52 (range, 0:30–1:14; P < .001). Participants’ performance for structure identification improved from 9.7 (range, 8–13) to 12 (range, 10–13) of 14 structures (P < .05). The average time to completion decreased from 14:6 (range, 12:08–18:30) to 9:34 (range, 4:40–15:54; P < .01). After instruction, all 6 participants identified and measured the cross‐sectional area of the median nerve, identified and measured a zone 3 flexor tendon gap, and identified a simulated flexor digitorum profundus avulsion and its level of retraction (P < .05). Five of 6 successfully administered an US‐guided injection to the extensor carpi ulnaris subsheath. Conclusions After a 30‐minute instructional session, hand surgery fellows can achieve a basic level of US competency.

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Learning curve of office-based ultrasonography for rotator cuff tendons tears

Abstract: Diagnostic study, Level II.

Cited by 32 publications

References 20 publications

Direct Measurements of the Tendon

Direct Measurements of the Tendon

Ultrasonography of the metacarpophalangeal joints in healthy subjects using an 18 MHz transducer.

Evaluation of the Acquisition of Ultrasound Proficiency in Hand Surgery Fellows

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