Module Directory

This module has been designed for musculoskeletal clinicians with an interest in rheumatology and ultrasound imaging. The role of Point of Care Ultrasound, (PoCUS) in musculoskeletal practice is becoming well-established and has highlighted the potential for this approach to be integrated into rheumatology practice: Point of Care Rheumatology Ultrasound, (PoCRUS).

Rheumatology patients often present with conditions that require prompt commencement of appropriate management. The current evidence provides a robust justification to draw on assessment strategies that facilitate clinical decision making and diagnosis. Conditions considered include: polyarthritis such as rheumatoid arthritis, oligoarthritis, monoarthritis, polymyalgia, suspected GCA and large vessel vasculitis; This module is attractive to those aiming for a greater understanding of the role of probability-based algorithms in rheumatology and how these can significantly influence condition evaluation, categorisation and management in patients presenting to early arthritis and fast track clinics.

The aims of this module are:

• To enable musculoskeletal clinicians to extend their understanding of the role of ultrasound imaging in the assessment and management of rheumatology patients. This understanding has the potential to underpin service developments such as introducing Point of Care Rheumatology Ultrasound (PoCRUS) into their own practice and musculoskeletal clinics.


• To provide strong links between current evidence and PoCRUS. This approach will enable clinicians and managers to explore new pathways to optimise resource management and patient experiences.

By the end of this module students will be expected to be able to:

1. Demonstrate a systematic understanding of the theoretical principles underpinning point of care rheumatology ultrasound and how these principles align with current clinical governance.


2. Apply advanced clinical reasoning relating to the role of point of care ultrasound imaging for rheumatology presentations.


3. Critically evaluate personal professional practice informed by current evidence.

Syllabus:

Overview of the probabilistic approach and its specific application to different presenting scenarios such as polyarthritis, oligoarthritis, monoarthritis, polymyalgia, suspected GCA and large vessel vasculitis;

Case discussions and hands-on practice on patients with different rheumatology scenarios;

Appropriate ultrasound scanning techniques and protocols will be demonstrated and practiced.

Themes covered:

• Common presentation scenarios in rheumatology;


• Application of a probability-based approach to evaluate individual presentations;


• Understand the role of point of consultation ultrasound in the probability-based algorithm;


• Recognize specific and sensitive ultrasound signs/patterns;


• Confirm/exclude different scenarios by applying ultrasound findings;


• Understand the individual settings and procedures for ultrasound scanning.

Live demonstrations and supervised hands-on workshops:

• Principles for applying ultrasound in rheumatology scenarios;


• Standardized sonographic scanning in clinical scenarios for: rheumatoid arthritis, spondyloarthritis, gout/crystal arthritis, PMR/GCA;


• The use of colour Doppler ultrasonography and ultrasound system settings;


• Identification of vascular sonoanatomy.

This module will be delivered via:

• Six 3-hour online sessions.

1. Overview of PoCRUS and technical requirements for scanning
2. Polyarthritis – application of PoCRUS and probability-based algorithm.
3. Oligoarthritis - application of PoCRUS and probability-based algorithm.
4. Monoarthritis - application of PoCRUS and probability-based algorithm.
5. Polymyalgia – application of PoCRUS and probability-based algorithm.
6. GCA - application of PoCRUS and probability-based algorithm.

• 2 days of face-to-face teaching on campus for practical scanning.

Teaching methods will be inclusive to neurodiversity and medical conditions, within the constraints of physical ability to use ultrasound imaging e.g. visual ability is needed.