Background:In the early detection of arthritis, such as psoriatic arthritis (PsA), ultrasound (US) of painful joints plays an important role in diagnosis. Pathological findings can be missed during clinical examination, especially if conducted by physicians who are not trained. Furthermore, several publications undermine the importance of early PsA detection in psoriasis patients and the key role of the dermatologists in this process.Objectives:The objective of this study was to examine a pilot musculoskeletal ultrasound (MSUS) course designed specifically for dermatologists.Methods:To assess the degree of US expertise of the participants, a questionnaire was conducted before the course. The course concept, based on The German Society for Ultrasound in Medicine (Deutsche Gesellschaft fur Ultraschall in der Medizin, DEGUM) covering only the most important US sections of all joints and focused on the detection of joint effusion and hyperperfusion. The course consisted of three modules and was carried out over 6 months. Figure 1 shows the modular course concept. A portable US device in combination with a tablet was provided to enable practice between the courses. The final teaching evaluation was carried out as an objective structured clinical examination (OSCE) consisting of three stations, each representing the three course modules. According to the following grade scoring system, the performance rating was checked: < 60 % failed, ≥ 60 - < 70 % sufficient, ≥ 70% - < 80 % satisfying, ≥ 80% - < 90 % good, ≥ 90 % very good.Results:Twelve dermatologists participated. The mean age of our cohort was 39 years (SD ± 9.99 years) with nine females (75 %). Eight were specialists in dermatology in mean for 11.4 years (SD ± 11 years). Four were assistant physicians practicing dermatology in mean for 3.06 years (SD ± 0.97 years).The survey revealed no prior knowledge of MSUS. The overall mean score of all participants in the OSCE was 21.86 (SD ± 2.12) (87.44%) out of a total of 25 points resulting in a good grade. There was no statistically significant difference between the assistant physicians and the specialists in dermatology regarding the OSCE results. Table 1 shows the OSCE results.Table 1.Objective structured clinical examination (OSCE) mean results for all three stationsOSCEstationsMean absoluteMean absoluteStandard DeviationMean percentageStandard DeviationConfidence IntervalGrade118.9218.92+/- 3.0775.67%+/-12.27%67.87-83.46%Sufficient223.8323.83+/-0.9995.33%+/-3.94%92.83-97.84%Very good322.8322.83+/-0.3791.33%+/-1.49%90.39-92.28%Very goodOSCE station 1-321.8621.86+/-2.1287.44%+/-8.49%66.36-108.53%GoodConclusion:The innovative US teaching concept was able to demonstrate, that it is appropriate for the training of dermatologists in MSUS, independently of their age, experience in dermatology and US.Disclosure of Interests:Jakub Grobelski: None declared, Florian Recker: None declared, Dagmar Wilsmann-Theis: None declared, Wolfgang Hartung: None declared, Pantelis Karakostas: None declared, Peter Brossart: None declared, Valentin Schäfer Speakers bureau: AbbVie, Novartis, BMS, Chugai, Celgene, Medac, Sanofi, Lilly, Hexal, Pfizer, Janssen, Roche, Schire, Onkowissen, Royal College London, Consultant of: Novartis, Chugai, AbbVie, Celgene, Sanofi, Lilly, Hexal, Pfizer, Amgen, BMS, Roche, Gilead, Medac, Grant/research support from: Novartis, Hexal, Lilly, Roche, Celgene, Universität Bonn
Establishment and validation of a didactic musculoskeletal ultrasound course for dermatologists using an innovative handheld ultrasound system – the MUDE study (Musculoskeletal Ultrasound in Dermatology)
