Previous studies have looked at accuracy of those with formal training using ultrasound (US) to evaluate patients with musculoskeletal injuries in a clinical setting. Due to limited and delayed access to magnetic resonance imagining (MRI) in Canada, many practitioners are utilizing US in their clinics with little to no formal training as part of their clinical evaluation in the diagnosis of rotator cuff (RC) tear. The Pan Am Clinic Research Team is undertaking a study to investigate whether US without formal training changes the diagnosis and treatment of patients that may have a RC tear.
Five surgeons at the Pan Am Clinic each performed clinical exams on 50 patients referred for a suspected RC tear at their initial visit. They performed their usual clinical exam and systematically recorded their findings and documented an initial treatment plan. They then performed an US exam and recorded any changes in their findings and plan based on this new information. They then read the patient’s MRI and once again, recorded any changes in their findings and plan. The findings and plan at each stage of this process were compared, to determine if the addition of US allowed the surgeon to be more accurate in their diagnosis and thus, be more informed in their treatment planning process.
This is a ‘real world’ study in the use of a diagnostic tool that is being used in many facilities due to a lack of access to other options. The outcome of this study will demonstrate the value and limitations of surgeons with no formal technical training in ultrasonography, using US as an additional tool in their initial consultations with patients.
This study may provide evidence to support or negate the use of US by untrained clinicians as an adjunct to current clinical evaluation. If shown to be effective, patient care may be shown to be more informed with US. However, this study may demonstrate that US is only effective when performed by a trained technician.