title: Teaching enthesis ultrasound: experience of an ultrasound training workshop.
abstract: To evaluate a standardised enthesis ultrasound training method, a workshop was conducted to train rheumatologists on enthesis ultrasound. After a theoretical session about ultrasound elementary enthesis lesions (changes in tendon architecture/thickness, bone proliferation/erosion, bursitis or Doppler signal), a reading exercise of 28 entheses' ultrasonographic images (plantar fasciae, Achilles, origin and insertion of patellar tendon) was completed. Participants scored through an electronic multiple-choice device with six possible lesions in each enthesis. To assess the adequacy and efficacy of the workshop, we explored the following: (1) subjective outcomes: a 12-item structured satisfaction questionnaire (graded 1-5 using Likert scale) and (2) objective outcomes of reliability: sensitivity (Se), specificity (Sp) and percentage of correctly classified cases (CC). Forty-nine participants attended the workshop. The satisfaction questionnaire demonstrated a 4.7 mean global value. The inter-reader Kappa reliability coefficient was moderate for the plantar fascia (0.47), Achilles tendon (0.47), and distal patellar tendons (0.50) and good for the proximal patellar tendon (0.63). The whole group means comparing to teachers' consensus were as follows: (a) plantar fascia: Se, 73.2%; Sp, 87.7%; CC, 83.3%; (b) Achilles: Se, 66.9%; Sp, 85.0%; CC, 79.5%; (c) distal patellar tendon: Se, 74.6%; Sp, 85.3%; CC, 82.1%; and (d) proximal patellar tendon: Se, 82.2%; Sp, 90.6%; CC, 88%. The proposed learning method seemed to be simple, easily performed, effective and well accepted by the target audience.
authors.affiliation: Rheumatology Unit, Instituto Português de Reumatologia, Rua Beneficência 7, 1050-034 Lisbon, Portugal. claudia.m.miguel@gmail.com
authors.forename: Cláudia
authors.initials: C
authors.lastname: Miguel
authors.forename: Eugenio
authors.initials: E
authors.lastname: De Miguel
authors.forename: Enrique
authors.initials: E
authors.lastname: Batlle-Gualda
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rejón
authors.forename: Leticia
authors.initials: L
authors.lastname: Lojo
mesh_terms: D000125:Achilles Tendon / Q000000981:diagnostic imaging; D004493:Education; D005205:Fascia / Q000000981:diagnostic imaging; D005528:Foot / Q000000981:diagnostic imaging; D006801:Humans; D017847:Patellar Ligament / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D012216:Rheumatic Diseases / Q000000981:diagnostic imaging*; D025242:Spondylarthropathies / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler