Probing the Unknown: My Musculoskeletal Ultrasound Training Journey

Joe Thomas MBBS, MD, MRCP, FRCP, DNB (Rheum), RhMSUS, RMSKS Dip MUS UCAM
Consultant Rheumatologist Aster Medcity, Kochi, Kerala

How has your journey been on the road of MSK USG so far?

My MSK USG journey started with a basic USG course at the ACR, following which I completed my USSONAR training. The training increased my passion and I went on to complete RhMSUS & RMSKS certification, 5 stages of EULAR MSK USG courses (last stage was TTT programme) and MUS UCAM diploma (Spain).

What are the different types of MSK ultrasound training programs available?

For rheumatologists there are mainly 2 options available. One is to do training from USSONAR and other is to do EULAR MSK USG courses. There are multiple online courses (I have done 3: MSK masters, Sonoskills and Clinevo medvidya). I prefer USSONAR over other programmes, because of their systematic approach. Multiple online courses help to improve learning the anatomy, which is the key in MSK USG. (eg: gulfcoast ultrasound institute,SMUG, etc)

Being a doctor, I get an added opportunity to treat sick co-riders, tourists, and the local public on the go.

Key factors to consider when choosing an MSK ultrasound training program?

Most important factor to consider while choosing to do a USG programme is to have passion for it. Generally, it is a lifelong learning process, and the most important thing is to keep doing it. Access to an USG machine is very important and one must do scanning on a regular basis. Most DM/DNB courses in India have USG in their training curriculum. What it now needs is a programme like USSONAR for Indian students, which will then felicitate accreditation, provide faculty expertise, and design a better curriculum at reduced cost. Presently only accreditation for rheumatologist is RhMSUS from ACR. Most of the other accreditation are primarily for MSK radiologist

How can rheumatologists balance clinical practice and training commitments when pursuing MSK ultrasound training?

Again, anything is possible if you have the passion for it. As for me, I keep scanning 2 days a week. When there are many rheumatologists in a centre, it is better to have one dedicated person in charge of USG. Most important role of USG is for MSK interventions. If you have access to a USG machine, all your joint injection including knee should be done under USG guidance.

Tips for youngsters wanting to learn MSK USG ?

Dedication and practice is key to MSK USG. It is important to have a systematic approach to MSK imaging in all cases to reduce errors. USG guided injection should be the norm, once you have mastered MSK USG.

What resources can supplement formal MSK ultrasound training to build proficiency over time?

Here are few suggestions regarding resources:
EULAR Ultrasound Scanning Guide (https://esor.eular.org/course/view.php?id=135)
ULTRASOUNDPAEDIA (https://ultrasoundpaedia.com/)
Ultrasound Cases (https://www.ultrasoundcases.info/)
Text books
1. Musculoskeletal Ultrasound for the Rheumatologist by George A.W. Bruyn, Wolfgang A. Schmidt.
2. Musculoskeletal Ultrasound in Rheumatology Review by Minna J. Kohler