Training Guidelines for Physicians, Chiropractors and Other Licensed Medical Providers Who Evaluate and Interpret Diagnostic Musculoskeletal Ultrasound Examinations

Physicians, chiropractors, and other licensed medical providers who perform and/or interpret diagnostic musculoskeletal (MSK) ultrasound examinations should be licensed medical practitioners who have a thorough understanding of the indications and guidelines for MSK ultrasound examinations as well as a familiarity with the basic physical principles and limitations of the technology of ultrasound imaging. They should be familiar with alternative and complementary imaging and diagnostic procedures and should be capable of correlating the results of these other procedures with the ultrasound findings. They should have an understanding of ultrasound technology and instrumentation, ultrasound power output, equipment calibration, and safety. Physicians, chiropractors, and other licensed medical providers responsible for diagnostic MSK ultrasound examinations should be able to demonstrate familiarity with the anatomic, physiologic, and pathophysiologic characteristics of the anatomic areas that are being examined. These individuals should provide evidence of the training and competence needed to perform and/or interpret diagnostic MSK ultrasound examinations successfully. The training should include methods of documentation and reporting of ultrasound studies.

Physicians (MD, DO, and DPM) who perform and/or interpret diagnostic MSK ultrasound examinations should meet 1 of the following:

  1. Completion of a residency and/or fellowship program that includes structured MSK ultrasound training and performance and/or interpretation and reporting of 150 diagnostic MSK ultrasound examinations, under the supervision of a physician qualified to perform MSK ultrasound examinations.

If completion of the residency and/or fellowship occurred more than 36 months ago, the following must be documented:

  1. The supervision and/or performance, interpretation, and reporting of at least 50 diagnostic MSK ultrasound examinations per year and 10 hours of AMA PRA Category 1 Credits™, American Osteopathic Association (AOACategory 1-A Credits, or Council on Podiatric Medical Education (CPME)-approved credits specific to MSK ultrasound within the previous 36 months.

  1. If the supervision and/or performance and interpretation of 50 diagnostic MSK ultrasound examinations per year cannot be documented, 1 of the following must be completed:

    1. 30 hours of AMA PRA Category 1 Credits™, AOA Category 1-A Credits, or CPME-approved credits specific to MSK ultrasound must be completed; or

    2. Certification in MSK ultrasound (active status) by the Alliance for Physician Certification and Advancement (APCA-RMSK).

or

  1. Completion of a residency and/or fellowship program in which the physician did not receive specific training in MSK ultrasound but can document subsequent involvement in the supervision and/or performance, interpretation, and reporting of 150 diagnostic MSK ultrasound examinations, plus 30 hours of AMA PRA Category 1 Credits™, AOA Category 1-A Credits, or CPME-approved credits specific to MSK ultrasound within the previous 36 months, including at least 1 ultrasound course that provided hands-on training in MSK applications; or certification in MSK ultrasound (active status) by the APCA-RMSK and at least 1 MSK ultrasound course that provided hands-on training in the previous 36 months.

or

  1. Completion of the American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology program. If completion of certification occurred more than 36 months ago, 10 hours of AMA PRA Category 1 Credits™ or AOA Category 1-A Credits specific to MSK ultrasound must be documented.

Chiropractors who perform and/or interpret diagnostic MSK ultrasound examinations should meet the following criteria:

Diplomate status granted by the American Chiropractic Board of Radiology or the American Chiropractic Board of Sports Physicians and the supervision and/or performance, interpretation, and reporting of 150 diagnostic MSK ultrasound examinations plus 1 of the following:

  1. 30 hours of AMA PRA Category 1 Credits™ or AOA Category 1-A Credits specific to MSK ultrasound within the previous 36 months, including at least 1 MSK ultrasound course that provided hands-on training; or

  2. Certification in MSK ultrasound (active status) by the APCA-RMSK and at least 1 MSK ultrasound course that provided hands-on training in the previous 36 months.

Other licensed medical providers* who perform and/or interpret diagnostic MSK ultrasound examinations should meet the following criteria:

Completion of an accredited doctor of physical therapy (DPT) program (or has earned the transitional DPT) or an accredited physician assistant program and documentation of involvement in the performance, interpretation, and reporting of 150 diagnostic MSK ultrasound examinations within the previous 36 months. Ultrasound examinations must be under the supervision of a licensed medical provider(s).

and

  1. Completion of 30 AMA PRA Category 1 Credits™ specific to MSK ultrasound and at least 1 ultrasound course that provided hands-on training in diagnostic MSK ultrasound within the previous 36 months; or

  2. Certification in MSK ultrasound (active status) by the APCA-RMSK and at least 1 MSK ultrasound course that provided hands-on training in the previous 36 months.

* Licensed medical providers, for the purposes of this document, include physicians, chiropractors, advanced clinical providers, and physical therapists.

 

Maintenance of Competence

All licensed medical providers who perform and/or interpret diagnostic MSK ultrasound examinations should demonstrate evidence of continuing competence in the interpretation and reporting of those examinations. A minimum of 50 diagnostic MSK ultrasound examinations per year is recommended to maintain the physician's skills.

 

Continuing Medical Education

All licensed medical providers who perform and/or interpret diagnostic MSK ultrasound examinations must complete 10 hours of AMA PRA Category 1 Credits™, AOA Category 1-A Credits, or CPME-approved credits specific to MSK ultrasound every 3 years.

 


Approved: 04/10/2013; Reapproved: 04/02/2014, 11/02/2014, 11/04/2017, 11/02/2019

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