Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Ultrasound has emerged in the field of rheumatology as a diagnostic aid for gout
and other similar forms of arthritis. While a number of studies have looked into the test characteristics of
ultrasound in diagnosing gout, only a few studies have examined the correlation between user experience
with soft tissue ultrasound and diagnostic precision. Our study seeks to examine the correlation between
the diagnostic accuracy of clinicians for gout using ultrasound and factors pertaining to experience and
training.
Methods: Graduates of a MSUS (musculoskeletal ultrasound) training program were asked to
anonymously complete a set of multiple-choice questions (single best answer type) asking for the most
likely patient diagnosis based on de-identified ultrasound images of bilateral knee and 1st
metatarsophalangeal joints from patients with non-tophaceous, crystal proven gout (n=6), crystal proven
calcium pyrophosphate arthropathy (n=5), or synovial fluid and radiograph supported osteoarthritis (n=2).
No normal images were included in the questionnaires. They were also asked information regarding the
use of MSUS within the participant’s practice/fellowship, years in practice, MSUS CME (Continuing
Medical Education) scores. Participants were categorized into quartile groups based upon prior final exam
scores. We used Wilcoxon Signed Rank Test and Spearman's Rank Correlation Co-efficient methods for
the statistical analysis.
Results: Survey was sent to 240 clinicians, 32 graduates responded to the survey, 10 of which did not
answer demographic questions. Clinicians with 5 or more years of practice had more correct answers in
gout questions than the ones who practice less than 5 years (76% accurate answers in gout questions vs
54%, p<0.05; r=0.54). They also had more correct answers in overall questions including gout, pseudo-
gout and OA compared to the clinicians who practice for less than 5 years, however this was not clinically
significant (64% accurate answers in overall questions vs 52%, p= 0.08; r=0.32). Differences in gout
diagnosis accuracy based on CME credits was not statistically significant (p= 0.2). There was no
correlation found between general MSUS training exam scores and accuracy in diagnosing gout.
Conclusion: This is the first study which shows how the length of time in practice affects the accuracy in
diagnosing gout, and that this effect is more significant that extent of CME hours or MSUS training exam
performance. However, it should be noted that the training exam performance was not specific to gout.
Disclosure: B. Elkiran, None; E. Y. Kissin, None.
To cite this abstract in AMA style:
Elkiran B, Kissin EY. Experience Matters in Ultrasound Assessment of Gout [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/experience-matters-in-ultrasound-assessment-of-gout/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/experience-matters-in-ultrasound-assessment-of-gout/