Training Guidelines for Physicians and Chiropractors Who Perform Ultrasound-Guided Musculoskeletal Interventional Procedures

Physicians and chiropractors who perform ultrasound-guided musculoskeletal (MSK) interventional procedures 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 as they pertain to diagnostic examinations and interventional procedures. 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 and chiropractors responsible for ultrasound-guided MSK interventional procedures 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 ultrasound-guided MSK interventional procedures successfully. The training should include methods of documentation and reporting of ultrasound studies.

Physicians (MD, DO, and DPM) who perform ultrasound-guided MSK interventional procedures should meet at least 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 50 diagnostic MSK ultrasound examinations and 50 ultrasound-guided interventional procedures, under the supervision of a physician qualified to perform MSK ultrasound examinations.

If completion of residency and/or fellowship occurred more than 36 months ago:

a. The supervision and/or performance, interpretation and reporting of at least 50 diagnostic MSK ultrasound examinations within the previous 36 months and 50 ultrasound-guided interventional procedures per year and 5 hours of AMA PRA Category 1 Credits™ specific to MSK ultrasound must be documented.

b. If the supervision and/or performance and interpretation of 50 diagnostic MSK ultrasound examinations within the previous 36 months and 50 ultrasound-guided interventional procedures per year cannot be documented, 30 hours of AMA PRA Category 1 Credits™, American Osteopathic Association (AOA) Category 1-A Credits, or Council on Podiatric Medical Education (CPME)-approved credits specific to MSK ultrasound must be completed, including at least 1 ultrasound course that provided hands-on training in MSK interventional applications.

or

2. 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 50 diagnostic MSK ultrasound examinations within the previous 36 months and 50 ultrasound-guided interventional MSK procedures per year, plus 30 hours of AMA PRA Category 1 Credits™, AOA Category 1-A Credits, or CPME-approved credits specific to MSK ultrasound must be completed, including at least 1 ultrasound course that provided hands-on training in MSK interventional applications.

or

 

3. Completion of the American College of Rheumatology Musculoskeletal Ultrasound Certification in Rheumatology program. If completion of certification occurred more than 36 months ago, 5 hours of AMA PRA Category 1 Credits™ specific to MSK ultrasound must be documented.
 

Chiropractors who perform ultrasound-guided MSK interventional procedures should meet the following criteria:

Diplomate status granted by the American Chiropractic Board of Radiology (ACBR) or by the American Chiropractic Board of Sports Physicians (ACBSP) and the supervision and/or performance, interpretation, and reporting of 50 diagnostic MSK ultrasound examinations within the previous 36 months and 50 ultrasound-guided interventional procedures per year, plus 30 hours of AMA PRA Category 1 Credits™ or AOA Category 1-A Credits specific to MSK ultrasound, including at least 1 MSK ultrasound course that provided hands-on training in MSK interventional applications.

Chiropractors who perform interventional ultrasound procedures must be in compliance with the regulations of the state in which they practice.

Maintenance of Competence

All physicians and chiropractors who perform ultrasound-guided MSK interventional procedures should demonstrate evidence of continuing competence in performance of these procedures. A minimum of 50 ultrasound-guided interventional procedures per year is recommended to maintain the physician's or chiropractor's skills.

Continuing Medical Education

Physicians and chiropractors who perform ultrasound-guided MSK interventional procedures must complete 5 hours of AMA PRA Category 1 Credits™, AOA Category 1-A Credits, or CPME-approved credits specific to MSK ultrasound every 3 years.

 

Approved: 11/02/2014;

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