Evidence map›Paper›PMID 36008579›Full record

ArticleClinical rheumatology2022

North American musculoskeletal ultrasound scanning protocol of the shoulder, elbow, wrist, and hand: update of a Delphi Consensus Study.

Narandra K Bethina, Karina D Torralba, Kristal S Choi, Robert M Fairchild, Amy C Cannella, Lorena Salto, Eugene Y Kissin, Janeth Yinh, Manushi Aggarwal, Ralf Thiele and 2 more

Abstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in Clinical rheumatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 9 institutions in 1 country.

Narandra K BethinaDivision of Rheumatology and Clinical Immunology, University of Vermont Medical Center, Burlington, VT, 05401, USA. narandra.bethina@uvmhealth.org.
Karina D TorralbaDivision of Rheumatology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA.
Kristal S ChoiDivision of Rheumatology, University of CA-Los Angeles, Los Angeles, CA, USA.
Robert M FairchildDivision of Immunology and Rheumatology, Stanford University, Stanford, CA, USA.
Amy C CannellaDivision of Rheumatology, University of Nebraska Medical Center, Omaha, NE, USA.
Lorena SaltoSchool of Medicine, Loma Linda University, Loma Linda, CA, USA.
Eugene Y KissinDivision of Rheumatology, Boston University, Boston, MA, USA.
Janeth YinhDivision of Rheumatology, Harvard Medical School, Boston, MA, USA.
Manushi AggarwalDivision of Rheumatology, Loma Linda University Health, Loma Linda, CA, USA.
Ralf ThieleDivision of Allergy/Immunology and Rheumatology, University of Rochester, Rochester, NY, USA.
Midori J NishioJohn Muir Rheumatology, Walnut Creek, CA, USA.
for USSONAR
Loma Linda University · USBoston University · USHarvard University · USJohn Muir Health · USStanford University · USUniversity of California, Los Angeles · USUniversity of Nebraska Medical Center · USUniversity of Rochester Medical Center · USUniversity of Vermont Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION/

objectivesThere has been an increase in the proficiency and utilization of ultrasound among North American rheumatologists over the past decade. This study aims to create an updated upper extremity scanning protocol to inform ultrasound curriculum development for the American College of Rheumatology affiliated fellowship programs and guide clinical practice patterns in North America.

methodThree Delphi survey rounds were used to reach consensus on tiered-mastery designations for scan views of the shoulder, elbow, wrist, and hand joints. The survey was disseminated by Qualtrics™ to 101 potential participants with ultrasound experience. High agreement was defined as having ≥ 85% consensus and final tier designation as > 50% agreement for a preferred tier. Changes in responses were evaluated by McNemar's chi-square test.

resultsConsensus was achieved for 70% of scan views of the upper extremity joints. Two views-ulnar transverse view of the wrist and the radial/ulnar orthogonal views over metacarpophalangeal joints 2 and 5 of the hand-were upgraded from tier 2 to tier 1. The suprascapular transverse and the axillary longitudinal views of the shoulder were downgraded from tier 2 to tier 3. A new anterior transverse view of the elbow was added to the protocol with tier 1 designation.

conclusionsThis study reflects the current opinions of North American rheumatologists for scanning upper extremity joints and provides support for the updated protocol and guidance for educators in rheumatology ultrasound. Key Points • Ultrasound scan views of the metacarpophalangeal, wrist, elbow, and glenohumeral joint recesses and views of the biceps and rotator cuff tendons at the shoulder were perceived as essential views of the upper extremity scanning protocol for rheumatologists to master and perform routinely. • A targeted scanning approach of the upper extremity joints may be considered when focal symptoms are present. • The North American Musculoskeletal Ultrasound Scanning Protocol shares some similarities with existing musculoskeletal ultrasound protocols of other specialties and worldwide rheumatology societies but varies in the extent of examination and emphasis on certain specialty-specific focuses.

Indexed as

ElbowShoulder JointDelphi TechniqueHumansShoulderUpper ExtremityWristMusculoskeletal ultrasoundScanning protocolUltrasound of the elbowUltrasound of the shoulderUltrasound of the wrist and ultrasound of the hand

Identifiers

PMID36008579
OpenAlexW4293093324

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.