Clinical implementation of musculoskeletal ultrasound in rheumatology in Austria.
The aim of the study is to assess the clinical implementation of musculoskeletal ultrasound (MSUS) in rheumatology in Austria. A survey was conducted among Austrian rheumatologists and physicians of other specialties with a focus on rheumatology. The questionnaire was designed by the members of the Austrian Radiology-Rheumatology Initiative for Musculoskeletal UltraSound including the following items: demographics, access to MSUS and MSUS training, application of MSUS to support diagnosis, monitoring and treatment decisions, and obstacles for the routine performance of MSUS. Eighty-eight (21.9 %) out of the 402 surveyed physicians responded. No access to MSUS and/or inadequate training in the technique was more commonly reported by senior (>50 years; 64.3 and 67.7 %, respectively) than by younger physicians (16.7 %, p = 0.01 and 18.5 %, p < 0.001, respectively). The lowest availability of sonography was found among senior rheumatologists (25.0 %, p = 0.001 compared to the total group). MSUS is routinely used for diagnosis and/or monitoring purposes by 12.5 % of physicians and 20.5 % perform sonography in clinically unclear cases. A limited number of physicians apply the method to support treatment decisions and/or to evaluate treatment success. The most important obstacles for routine application of MSUS in rheumatology are limited access to ultrasound machines, lack of training/education in the technique, and time constraints in daily routine. Low access to high-end ultrasound devices, lack of training, and time constraints may explain the low appreciation of MSUS among Austrian physicians evaluating patients with rheumatic diseases.
Department of Internal Medicine, General Hospital of Kufstein, Endach 27, 6330, Kufstein, Austria.
Christina
C
Duftner
Claudia
C
Schüller-Weidekamm
Peter
P
Mandl
Thomas
T
Nothnagl
Michael
M
Schirmer
Franz
F
Kainberger
Klaus
K
Machold
Christian
C
Dejaco
D001291:Attitude of Health Personnel; D001317:Austria; D002983:Clinical Competence; D004501:Education, Medical; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D011379:Prognosis; D012216:Rheumatic Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D012219:Rheumatology / Q000193:education / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014463:Ultrasonography / Q000706:statistics & numerical data