Article Text

SP0200 Competency Assessment in US: An Example of Qualification Offered by EULAR
  1. A. Iagnocco
  1. Sapienza Università di Roma, Rome, Italy


The use of musculoskeletal ultrasound in rheumatology clinical practice has become widespread with increasing demand from rheumatologists attending EULAR Sonography Courses and participating in educational activities in the field. However, musculoskeletal ultrasound is widely considered an operator dependent imaging technique for which high level training and appropriate competency assessment are crucial in order to ensure the quality of ultrasound examinations. EULAR offers a huge educational programme in musculoskeletal ultrasound, with a number of own branded multi-level live sonography courses and an online introductory course on ultrasound, of which high quality structure and content is ensured. In addition, EULAR grants “scientific endorsement” as a mark of scientific quality to selected courses organised by established experts. Moreover, EULAR guidelines and recommendations on how to perform musculoskeletal ultrasound in rheumatology, and for the content and conduct of ultrasound, including teach-the-teachers, courses have recently been published, thus filling a knowledge gap in the field.

There was however, still the need for assessing the level of competency of delegates attending these educational courses in order to improve and regulate the skills of rheumatologists performing ultrasound. As a result, the EULAR competency assessment in musculoskeletal ultrasound in rheumatology was launched in 2015 with this objective. This new system represents an example of certification offered by EULAR and is based on 2 levels of competency: 1) Level 1 (i.e. the minimum level required to independently perform full rheumatologic musculoskeletal ultrasound, the contents of which are included in the EULAR online, basic, intermediate and advanced courses). 2) Level 2 (i.e. the minimum level required to teach musculoskeletal ultrasound). The EULAR faculty, a group of highly qualified and experienced experts in the field, assess the attendees of the annual EULAR sonography and teach-the teachers courses in order to provide EULAR certification approving their level of competency. All these procedures are regulated by rules available on the EULAR web site (

The competency assessment requirements are reported below:

  • To complete the EULAR online MSUS course successfully.

  • To attend the Basic and Intermediate EULAR MSUS course, or equivalent EULAR scientifically endorsed MSUS course and the Advanced EULAR MSUS course with a maximum of 2 years in between each course.

  • To perform and document a minimum of 10 standardized complete MSUS examinations of each joint region (i.e. shoulder, elbow, wrist&hand, hip, knee, ankle&foot) of different normal subjects, after having attended the Basic MSUS course (EULAR or EULAR endorsed).

  • To perform a minimum of 200 documented MSUS examinations of different anatomic areas(i.e. shoulder, elbow, wrist&hand, hip, knee, ankle&foot) of different patients with rheumatologic diseases that covers the full range of conditions included in the basic and intermediate level, after having attended the Intermediate MSUS course.

  • The latter requirement of performing normal and pathological ultrasound images can be replaced with the achievement of level 1,2 or 3 of MSUS competency in rheumatology as stated by EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology). (Ref. Terslev L, et al. Ultraschall in Med; published online May 21, 2013;

  • To successfully pass a practical exam that takes place during the Advanced EULAR MSUS course.

  • To have achieved level 1 competency.

  • To attend the annual EULAR MSUS Teach the Teacher course and successfully pass the theoretical and practical examination on MSUS teaching capability that takes place during said course.

  • The level 2 competency certification can be delivered under particular circumstances (and after having verified the particular requirements, by the EULAR Faculty members) to MSUS experts who have been a teacher in a EULAR MSUS Teach the Teacher course within the previous 3 years or have been a teacher in three Intermediate/Advanced EULAR MSUS courses within the previous 5 years.

Key messages:

  • Appropriate training and competency assessment are highly important to ensure an appropriate and skilled use of musculoskeletal ultrasound by rheumatologists

  • The EULAR competency assessment in musculoskeletal ultrasound represents a unique opportunity to guarantee a high level of competency of rheumatologist ultrasonographers

Disclosure of Interest None declared

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