Expert Consensus Recommendations for Musculoskeletal Ultrasound Education in Canadian Rheumatology Residency Programs
In brief
Canadian rheumatology residencies reach consensus on 42 core musculoskeletal ultrasound competencies
A three-stage Delphi process involving experts from 7 of 12 Canadian programs identified 42 essential and 38 optional ultrasound items, which were grouped into 33 competencies covering hands, wrists, MTP joints, knee and ankle. All core items were judged clinically valuable, learnable for residents, and feasible for national implementation, laying groundwork for a standardized MSUS curriculum.
- Journal
- Arthritis care & research (Q1)
- Published
- 31 July 2026
- Study design
- Practice guideline / consensus
- Evidence level
- Level 1, High (CEBM 1c)
- Authors
- Maria F Powell, Steven G Thomson, Sahil Koppikar, Susan G Barr, Shirley Lake, Lihi Eder, et al.
- PMID
- 42535412
- DOI
- 10.1002/acr.80126
Why clinicians should know about it
- Picked for Rheumatology (top studies of the week, 2 August 2026): Expert consensus recommendations for MSUS education in rheumatology residency
Abstract
OBJECTIVE: We aimed to develop expert consensus recommendations for musculoskeletal ultrasound (MSUS) education in Canadian rheumatology residency programs. METHODS: This three-stage consensus study used an international working group of 13 MSUS experts and 5 non-expert stakeholders and incorporated cognitive load theory to ensure educational feasibility. In stage one, MSUS experts participated in a modified nominal group technique (NGT) to generate and prioritize items for stage two. In stage two, the working group completed three survey rounds using a modified Delphi technique, with consensus defined as agreement >70%. In stage three, experts reviewed items from stage two in a structured focus group, rating each for clinical utility, learnability, and feasibility of national implementation. RESULTS: The NGT generated 30 prioritized anatomical areas and pathologies. The Delphi working group represented 7/12 (58%) Canadian rheumatology programs (English stream) and two U.S. experts. The response rate across all Delphi rounds was 100%. Round one included 83 items, round two included 52, and round three included nine. Consensus was reached on all but five items, yielding 42 core and 38 optional items. In the structured focus group, consensus was reached that all core items are clinically valuable, learnable for rheumatology residents, and feasible for national implementation. Core items were then organized into 33 MSUS competencies, encompassing general ultrasound skills, features of inflammatory arthritis in the hands, wrists, and MTP joints, double contour sign in the MTP joints, and effusion detection in the knee and ankle joints. CONCLUSION: These recommendations provide a foundation for standardized MSUS curricula in rheumatology residency programs.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.