Report of the 6th EULAR Online Introductory Ultrasound Course

2017

Ettore Silvagni My name is Ettore, and I’m a trainee rheumatologist at Ferrara University, St. Anna Hospital, Italy. Despite an important knowledge of clinical practice that I have made in these years at a rheumatology tertiary referral hospital, a limit in my learning process was lack of ecographic expertise. Aiming to improve in my ecographic training, the Italian Society for Rheumatology (SIR) Basic Course on Musculoskeletal Ultrasound (MSUS) in Rheumatology held in Rome in 2016 (with EULAR scientific endorsement) was an important boundary to start learning. It was important, not only to improve my knowledge of the normal ecographic structure of tissues and the fundamental pathologic alterations seen in current clinical practice, but also the elementary rules of holding the probe and the basic settings of the Musculoskeletal Ultrasound (MSUS) machine and Doppler physics. Nevertheless, without ongoing clinical application in daily practice, the theory remains theory and ecographic ability does not improve. In this context, starting subsequently applying with regularity at MSUS machine in ambulatory setting, with the help of my tutor, became important to maintain the acquired notions. Simultaneously, I started applying for the EULAR Online Introductory Ultrasound Course, taking the opportunity of an initiative by SIR, which contributes in refunding clinicians who succeed in passing the examination after one year. The combined practical application and the regular study of online modules of the course was the key to developing my ecographic expertise. The online course was structured in seven modules with a linear design, from the basis of general MSUS physics to normal and pathological sonoanatomy of the principal joints and the rules of scanning techniques. The printed textbook was useful in outlining the correct way to explore a normal joint, fixing the correct view of each scan (with a well provided number of pictures) and linking the alterations of normal sonoanatomy to determinate pathological features, in line with OMERACT definitions of ultrasonographic pathology. Each online module comprehended videos of scanning techniques of each joint and normal or pathological views, interactive clinical cases with focus on pathological MSUS alterations, a list of questions which guarantees the step to the following session and an “In-depth discussion” session with clarification of frequent clinical problems and updated deepening. Finally, a conclusive examination permitted me to complete the course and to obtain a certificate of attendance.

In my experience, the combination of current clinical application and the progressive study of online modules was the key to improve and to obtain benefit from this course, which I recommend to trainee rheumatologists who start their clinical experience in MSUS, in the aim to direct a correct initial systematic learning. Acquiring a basic expertise of ultrasound is a fundamental step to increase our knowledge of joint pathology and to guide subsequent implementation in MSUS ability. Ettore Silvagni Department of Medical Science, Rheumatology Unit, University of Ferrara, Cona (Ferrara), Italy.