Background/Purpose: Musculoskeletal (MSK) imaging is widely used in rheumatology for diagnosis and management of arthritis. Although the technical and performance properties of MSK imaging tests are well recognised, few studies have examined the patient experience of undergoing these tests. The aim of this study was to understand the patient experience of MSK imaging tests for investigation of inflammatory arthritis, and factors that contribute to this experience.

Methods: In this mixed methods study, we conducted a thematic analysis of semi-structured interviews with 33 patients who had undergone a recent peripheral joint conventional radiograph, ultrasound, computed tomography or magnetic resonance imaging scan for investigation of inflammatory arthritis. Data from these interviews were used to generate an 18-item questionnaire about the experience of MSK imaging which was posted to rheumatology clinic patients within six weeks of peripheral joint imaging. Variables associated with the overall patient experience of the test were analysed using stepwise linear regression models.

Results: Analysis of the interviews identified six themes; knowledge about the test, the role of imaging in clinical care, awareness of potential harm, discomfort, experience of waiting, and ‘seeing is believing’. Patient understanding was informed by the information they received and previous experience of the test. Patients perceived imaging as part of clinical care and believed the benefits of having the test outweighed the potential risks. Discomfort was experienced by some patients, both emotional due to negative experiences of interactions with staff and claustrophobia, and physical due to positioning for the test. Some patients felt anxious about waiting times for the test and for receiving results. Viewing of the images (particularly during ultrasound) improved understanding of disease and gave a sense of personal involvement in their arthritis treatment. Completed questionnaires were available from 132 patients. In regression analysis (Table), a strong negative association was observed between the ‘Discomfort during the test’ item and the overall experience of the test (standardised beta 0.35, p<0.001). ‘Staff made the experience better’ (0.26, p<0.001) and ‘Information provided’ (0.28, p<0.001) were positively associated with the overall experience of the test. For those who viewed their images, ‘looking at the images with my doctor made me feel more involved in my care’ (0.24, p<0.019) was also associated positively with overall experience.

Conclusion: Factors before, during and after a musculoskeletal imaging test contribute to the patient experience. The overall experience is most influenced by patient discomfort, interactions with staff during the test, information provided, and viewing images to improve patient involvement in clinical care.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-patient-experience-of-musculoskeletal-imaging-tests-for-investigation-of-inflammatory-arthritis-a-mixed-methods-study/