Filippou G, Adinolfi A, Delle Sedie A, Filippucci E, Iagnocco A, Porta F, Sconfienza L M, Tormenta S, Di Sabatino V, Picerno V, Frediani B
Rheumatology Unit, University of Siena, Siena.
Reumatismo. 2014 Nov 6;66(3):233-9. doi: 10.4081/reumatismo.2014.739.
Shoulder pain is a common condition in the rheumatologist's practice, yet there are no guidelines on how to report shoulder ultrasound (US) examinations. The aim of this study was to compare scanning and reporting techniques performed by radiologists and rheumatologists and identify any discrepancies between the two. The participants in this study were five rheumatologists and two radiologists specialized in musculoskeletal US. The study was divided in 2 phases. In the first phase, each participant performed an US of 3 patients and reported the findings without knowing the patient diagnosis and the findings reported by the other operators. Other three investigators reported the US technique of each operator. Reports and images were subsequently compared to identify any discrepancies and reach consensus on a common approach. In the second phase, a US scan was performed on a fourth patient in a plenary session to assess feasibility and efficacy of the common approach The US scanning technique was similar for all operators. The differences in reporting emerged in the description of the rotator cuff disease. Radiologists provided a detailed description of lesions (measurements along 2 axis and scoring of lesions), whereas rheumatologists described carefully the inflammatory changes. The experts concluded that lesions should be measured along 2 axes and the grade of degeneration and the age of the lesion should be reported. Another difference emerged in the description of the irregularities of the bone surface. The experts concluded that the term erosion should be used only when an inflammatory joint disease is suspected. This study led to the clarification of some inconsistencies in US reporting, and represented an interesting collaborative experience between radiologists and rheumatologists.
肩部疼痛是风湿病医生临床工作中的常见病症，但目前尚无关于如何报告肩部超声（US）检查结果的指南。本研究旨在比较放射科医生和风湿病医生的扫描及报告技术，并找出两者之间的差异。本研究的参与者包括五位风湿病医生和两位专门从事肌肉骨骼超声检查的放射科医生。该研究分为两个阶段。在第一阶段，每位参与者对3例患者进行超声检查，并在不知道患者诊断及其他操作人员报告结果的情况下报告检查结果。另外三位研究人员报告每位操作人员的超声检查技术。随后对报告和图像进行比较，以找出差异并就通用方法达成共识。在第二阶段，在全体会议上对第四例患者进行超声扫描，以评估通用方法的可行性和有效性。所有操作人员的超声扫描技术相似。在肩袖疾病的描述方面出现了报告差异。放射科医生对病变进行了详细描述（沿两个轴测量并对病变进行评分），而风湿病医生则仔细描述了炎症变化。专家们得出结论，应沿两个轴测量病变，并报告退变程度和病变年龄。在骨表面不规则性的描述方面也出现了另一个差异。专家们得出结论，仅在怀疑存在炎性关节疾病时才应使用“侵蚀”一词。本研究澄清了超声报告中的一些不一致之处，代表了放射科医生和风湿病医生之间一次有趣的合作经历。
