Musculoskeletal ultrasound: an effective tool to help medical students improve joint inflammation detection?
OBJECTIVE
The objective of this study was to evaluate whether musculoskeletal (MS) ultrasound (US) can be useful in helping medical students to detect joint inflammation through physical examination.


METHODS
The study was performed by two groups of four 6th year medical students. None had received any previous training in the clinical examination of joints or the use of ultrasound. Students were put through a 5-session training programme on the clinical detection of either knee [group 1] or metacarpophalangeal (MCP) [group 2] inflammation. After an initial training session on physical examination of normal and inflamed joints, the students examined 170 joints from 41 patients attending the hospital outpatient clinic in 4 separate sessions. The same joints were assessed for synovitis with US with the ensuing data compared to that of the students and analyzed for concordance with Cohen's unweighted kappa.


RESULTS
In total 60 knees [group 1] and 110 MCP [group 2] were evaluated. The agreement between the presence of arthritis detected by the students in the four sessions and the presence of synovitis detected by US improved from the session I to sessions III with a marked improvement in the last session.


CONCLUSIONS
MSUS may be an effective technique for helping students to acquire the ability to detect joint inflammation.
Faculty of Medicine, Universidad Complutense, Madrid, Spain.
Aníbal
A
Ruiz-Curiel
Faculty of Medicine, Universidad Complutense, Madrid, Spain.
María Dolores
MD
Díaz-Barreda
Faculty of Medicine, Universidad Complutense, Madrid, Spain.
Marta
M
González-Rodríguez
Faculty of Medicine, Universidad Complutense, Madrid, Spain.
Teresa
T
Martín-Delgado
Faculty of Medicine, Universidad Complutense, Madrid, Spain.
Adriana
A
Medrano-Antoñazas
Faculty of Medicine, Universidad Complutense, Madrid, Spain.
Raquel
R
Muñoz-González
Faculty of Medicine, Universidad Complutense, Madrid, Spain.
Silvia
S
Perales-Torres
Faculty of Medicine, Universidad Complutense, Madrid, Spain.
Javier
J
Sánchez-Montero
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. iustinajanta@yahoo.com.
Iustina
I
Janta
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Juan Carlos
JC
Nieto
Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain.
Luis
L
Collado-Yurrita
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Francisco Javier
FJ
López-Longo
Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Esperanza
E
Naredo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging*; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging; D008875:Middle Aged; D010808:Physical Examination; D013337:Students, Medical; D013585:Synovitis / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult