Background/Purpose: In the early detection of arthritis, such as psoriatic arthritis, 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 psoriatic arthritis detection in psoriasis patients and the key role of the dermatologists in this process. 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 covered only the most important US sections of all joints and focused on the detection of joint effusion and hyperperfusion. The course consisted of 3 modules and was carried out over 6 months. Graphic 1 shows the modular course concept. A portable US system 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)(5) consisting of 3 stations, each representing 1 of the course modules. Graphic 2 shows exemplary the course teaching sessions. 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 9 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.

Conclusion: The innovative teaching concept MUDE was able to demonstrate, that it is appropriate for the training of dermatologists in MSUS, independently of their age, experience in dermatology and US.

Graphic 1 Ultrasound Course Module Structure

Graphic 2 Practical exercises during the course

Table 1 Objective structured clinical examination results for all three stations in mean Module 1: representing the first OSCE station, Module 2: representing the second OSCE station, Module 3: representing the third OSCE station, overall: the mean result for all OSCE modules

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/establishment-and-validation-of-a-didactic-musculoskeletal-ultrasound-course-for-dermatologists-using-an-innovative-handheld-ultrasound-system/