Developing a Clinical Practice

As knowledge in musculoskeletal ultrasound training progresses, the next step is to utilize it in clinical practice. This is done by obtaining adequate equipment, developing scanning and interpreting skills, and taking the necessary steps to integrate these techniques into improvement in patient care.

OBTAINING AN ULTRASOUND MACHINE

Obtaining an ultrasound machine is the first and necessary step toward developing a clinical practice. It is virtually impossible to adequately progress without the machine for practice as well as clinical use. It is also typically the largest step a practitioner will make, as it requires a considerable financial investment. Currently, machines can vary in cost between twenty and two hundred thousand dollars. The quality of the machine tends to parallel the cost. Despite this, the machines have continued to improve to the extent that the lower cost portable machines can provide a high quality image that can easily be used in clinical practice.

There are a number of quality companies that make ultrasound machines that can be used for musculoskeletal medicine. It is prudent for a potential buyer to “test drive” different types of machines to determine the best choice for an individual practice. This can be done at meetings, by contacting the vendors directly for demonstrations, or finding other practitioners with a machine to assess. The desirable features of an ultrasound machine are dependent on the particular needs of the individual. For virtually all practitioners, however, the machine should have a high-resolution broadband linear transducer, be able to provide a high quality image and have digital storage. Determining the best company to use for ultrasound purchase is also individualized but it is advised to investigate which companies have the best customer service.

DEVELOP SCANNING AND INTERPRETING SKILLS

Practitioners have traditionally had to seek out opportunities to develop skills in musculoskeletal ultrasound. Until recently, formal training in this discipline was not available in most residency programs. As the field has grown, an increasing number of learning opportunities have developed that include didactic courses, instructional books, journal articles, and online videos. There are also a growing number of instructors that can teach their experience. Seeking out other individuals with the same interest can also be invaluable. Regular communication with a network of other practitioners doing similar evaluations can provide practical insight that might not be found in a typical journal or textbook. There is no substitute to practice time with the ultrasound machine.