by Laura Currie, B.S., RT(R), RDMS, RVT, RMSKS
As a sonography student in 1986, the subject of my graduation project was “Ultrasound Evaluation of the Rotator Cuff”. The procedure was in its infancy on the West Coast but beginning to see increased use in some regions of the country. The scans were performed by Radiologists with a particular interest in sonography and a willingness to accept the challenge.
I was fortunate to have worked with one of those Radiologist, Dr. Charles Pope, in Raleigh, NC from 1988 – 2005. Dr. Pope had a great working relationship with many of the Orthopedic Physicians in the capital city and they referred patients for shoulder ultrasounds first to rule out rotator cuff tears. Two days per week were reserved for shoulder patients and we averaged 16-20 rotator cuff scans per week. As ultrasound technology advanced, we were increasingly confident in diagnosing partial thickness tears, avulsion fractures and tendon calcifications in addition to complete tears. MRI procedures were seldom required for these patients.
In 2005 I relocated to Wilmington and began teaching in the CFCC Medical sonography program. I was surprised to find that ultrasound was not being used to diagnose rotator cuff tears in my new community. For the past 15 years, I have followed the growing MSK Sonography modality and watched from afar as it expanded to include scans of all upper and lower extremity joints. Yet after 15 years of continued growth in the MSK sonography field, my community remains underserved in this modality. While it is being used for guided therapeutics and surveillance of rheumatoid arthritis treatments, the use of ultrasound to diagnose joint/tendon injuries and pathologies has been quite slow to catch on here.
One reason for this delay is that MSK sonography is very operator dependent and our community lacks experienced MSK sonography practitioners. As with any new medical technique or procedure, appropriate training and practice is necessary. Some Radiologists have ultrasound scanning experience, but may not be comfortable in their ability to acquire MSK images. Orthopedic Physicians may also have been exposed to ultrasound use in their residencies and fellowships but the learning curve is steep and requires consistent exposure and practice.
Diagnostic Medical Sonographers already possess the foundation needed to learn MSK sonography and thus are able to hone the required skills at a faster pace. CFCC sought the opinion of the sonographers in our community and found sufficient levels of interest and desire to learn MSK sonography. In response to this interest, CFCC offered our first MSK Sonography Program in the spring of 2020. Our curriculum includes instruction in anatomy, scan techniques, protocols and pathologies of all upper and lower extremity joints. Students also learn the dynamic techniques that can be performed while scanning, which gives ultrasound an advantage over MRI scans.
Our first class of students included sonographers, Physical Therapists and Physicians Assistants from North Carolina, Virginia and California. Two sonographers in Wilmington completed the first MSK course and are ready to scan shoulders, elbows, wrists, hands, hips, knees, ankles and feet. Our Medical Sonography program plans to continue training additional sonographers and Physicians each year with the next MSK sonography course starting on January 7, 2021.
Education and training are essential to the availability of these cost-effective and convenient MSK sonography procedures in our community. Now that this training is available, what else needs to be done before MSK sonography can move forward in Wilmington? Is there an established dialogue between local Orthopedic Physicians and Radiologists to discuss interest in referring patients for MSK Sonography procedures and the procedures that are available? I look forward to hearing about MSK Sonography progress in the near future.
Laura Currie is a North Carolina native and a graduate of Greensboro College, Moses Cone Radiologic Technology Program and the UNC-CH Medical Sonography Program. She has worked as a staff sonographer at Duke University Medical Center and as a Supervisor and sonographer at Wake Radiology Diagnostic Imaging in Raleigh, NC.
Laura is registered through the American Registry of Diagnostic Medical Sonographers holding RDMS credentials in Abdomen, OB-GYN and Neonatal Neurosonography specialties. She also holds the RVT credentials for vascular technology and most recently earned the new RMSKS credential for musculoskeletal sonography. In addition, Laura is a registered Radiologic Technologist.
Laura is the Clinical Coordinator for the Medical Sonography Program at Cape Fear Community College and teaches sonographic physics, vascular sonography, obstetrical sonography and musculoskeletal sonography. She is a past president of the North Carolina Ultrasound Society and has worked with the Society as a member of the Board of Directors and an Administrator to bring quality continuing education to sonographers throughout the Carolinas.