Hospital General de Chilpancingo Dr. Raymundo Abarca Alarcón, Chilpancingo, Guerrero, Mexico.
Arthritis Care Res (Hoboken). 2014 Feb;66(2):270-6. doi: 10.1002/acr.22114.
To report the baseline knowledge of clinical anatomy of rheumatology fellows and rheumatologists from Argentina, Chile, Ecuador, El Salvador, Mexico, the US, and Uruguay.
The invitation to attend a workshop in clinical anatomy was an open call by national rheumatology societies in 4 countries or by invitation from teaching program directors in 3 countries. Prior to the workshop, a practical test of anatomic structures commonly involved in rheumatic diseases was administered. The test consisted of the demonstration of these structures or their function in the participant's or instructor's body. At one site, a postworkshop practical test was administered immediately after the workshop.
There were 170 participants (84 rheumatology fellows, 61 rheumatologists, and 25 nonrheumatologists). The overall mean ± SD number of correct answers was 46.6% ± 19.9% and ranged from 32.5-67.0% by country. Rheumatology fellows scored significantly higher than nonrheumatologists. Questions related to anatomy of the hand scored the lowest of the regions surveyed.
Rheumatology fellows and rheumatologists showed a deficit in knowledge of musculoskeletal anatomy that is of central importance in rheumatologic assessment and diagnosis. This gap may hinder accurate and cost-effective rheumatologic diagnosis, particularly in the area of regional pain syndromes. Presently, widespread use of musculoskeletal ultrasound (MSUS) by rheumatologists may be premature, since a key component of expert-level MSUS is the integration of an accurate knowledge of anatomy with the views obtained with the ultrasound probe.
报告来自阿根廷、智利、厄瓜多尔、萨尔瓦多、墨西哥、美国和乌拉圭的风湿科住院医师和风湿病学家的临床解剖学基础知识。
邀请参加临床解剖学研讨会的方式是由 4 个国家的全国风湿病学会公开召集,或者由 3 个国家的教学项目主任邀请。在研讨会之前,对常见于风湿性疾病的解剖结构进行了实际测试。该测试包括在参与者或讲师的身体上演示这些结构或其功能。在一个地点,在研讨会结束后立即进行了研讨会后的实际测试。
共有 170 名参与者(84 名风湿科住院医师、61 名风湿病学家和 25 名非风湿病学家)。总体平均(SD)正确答案数为 46.6%±19.9%,各国的范围从 32.5%至 67.0%不等。风湿科住院医师的得分明显高于非风湿病学家。与手部解剖相关的问题得分最低。
风湿科住院医师和风湿病学家在肌肉骨骼解剖学方面的知识存在明显不足,这对风湿评估和诊断至关重要。这一差距可能会阻碍准确和具有成本效益的风湿病诊断,特别是在区域性疼痛综合征领域。目前,风湿病学家广泛使用肌肉骨骼超声(MSUS)可能还为时过早,因为专家级 MSUS 的一个关键组成部分是将准确的解剖学知识与超声探头获得的图像相结合。