International Intensive Musculoskeletal MRI and Ultrasound Courses 2010/2011 in Asia
GO TO HOMEPAGE AND THEN VIEW LATEST POSTINGS AND UPDATES BY PROFESSOR DR JOHN GEORGE , MUSCULOSKELETAL RADIOLOGIST UNIVERSITY OF MALAYA BY SCROLLING TO BOTTOM OF PAGE
Rationale for MSK MRI and Ultrasound Courses

Main speaker : Prof Dr John George  MBBS(Adelaide) ,  DMRD(Aberdeen),  FRCR (UK)

The extensive CV of Professor George and his numerous publications, research , presentations and numerous research awards for credentialling him as main guest lecturer and course coordinator for the course is available on the University of Malaya website  http://ip158.fsktm.um.edu.my/meniscal.  
 
Prof George is the first practising in South East Asian radiologist to be ELECTED as a member of the Society of Skeletal Radiology of North America and proposer and founder member of the Asian Musculoskeletal Society.   He is also the proposer and founder member of the Asian Musculoskeletal Society . He has  practiced MSK Radiology for 18 years starting with training at Oxford and then training under the  famous  Prof Dr Donald Resnick of San Diego being his original mentor .John George is one of few radiologists who excels at reporting both MSK MRI and ultrasound.  He has reported well over 6000 MRI and 3500 MSK ultrasound over those years, many with arthroscopic correlation from the orthopaedic /radiology conferences held weekly. 
 
 But from all the testimonials you can read on this and the above website his strength is his ability to communicate and teach general radiologists basic MSK MRI interpretation and MSK ultrasound from doing and reporting hundreds of cases himself.  Now this is the person most of us want to learn from isnt it?  Someone actually practising weekly and done all the cases himself and not relying on sonographers?????  More than one radiologist has said " Prof George , you are saying the same things as at other courses but the way you put it across correlating gross anatomy and MRI images and ultrasound just makes it all make sense for the FIRST TIME "  .  Well , maybe that comes from the fact we teach so many medical students and have 56 residents so we have the art of simplying things and knowing how to present the images and correlations so well to help with the understanding of complex materials.
 
Other trainers:  Dr Daniel Makes , Dr Lincoln Gillam and those accredited by Prof Dr  John George to teach MSK MRI and demonstrate MSK Ultrasound including some of those we have trained personally in our previous courses who have graduated to be tutors .  Table trainers are also chosen from best delegates from previous courses who want a refresher.
 
MSK MRI and Ultrasound Symposium and Workshop  Programme: ( ALL COURSES FOR RADIOLOGISTS)   FIRST COURSE IN 2009 in July .
 
There is a general weakness in understanding Musculoskeletal MRI and Ultrasound anatomy and pathology.  The overall accuracy of reporting of MSK MRI by general radiologists is poor and there are only a few physicians who can perform screening Musculoskeletal Ultrasound examinations.  
 
There is therefore a need for training in diagnostic interpretation of MRI and also training in performing Musculoskeletal ultrasound , especially with emphasis on the strengths and weakness of MRI and ultrasound in day to day practice.   Radiologists need to be trained in correct detection and diagnosis and non radiologists who have less knowledge of radiological anatomy should be able to know enough anatomy to decide which is normal anatomy and what is abnormal(screening) and if possible suggest the actual abnormality noted.


This combined course aims to deliver the above in a  3 and a half day course for radiologists where the first day will be to learn in detail and recognise Musculoskeletal MRI and Ultrasound.

The radiologists will be taught in detail MSK MRI anatomy and then be given HOMEWORK each night to run through 8 -10 cases overnight to make a detailed report on the known anatomical structures and mention if they are normal or abnormal and possible pathology .  The next day  , Prof George will go over the cases and then go over another 10 cases on the spot with interactive question and answer on each case and explanation.  The cases are specially chosen to reflect the most common pathology of all the joints.
 
The schedule is as follows for the Radiologists which is very intensive : 
 
First day: Intensive MSK lectures on gross and radiological MRI and ultrasound anatomy.
Normal MRI cases and some pathology .
Homework :  8-10 Knee MRI cases to be answered using structured anwering sheet to comment on all structures. 
 
Second day:  Go over the 8-10 knee cases given the night before and also go over another 7-8 cases knee cases on the spot diagnosis interactively with Prof George .  
Homework : 8-10  Shoulder cases to be answered. 
MSK Ultrasound of the Knee and Hands on session .
 
Third day :  Go over the shoulder cases given the night before.
Homework:  Be given MRI cases and spot diagnosis cases via powerpoint slides to answer on elbow , wrist and ankle.  Radiologists will join non radiologists in MSK ultrasound lectures and demonstration.
MSK Ultrasound of the Shoulder and Hands on Session.
 
Fourth day:  Go over the elbow, wrist and ankle cases .   Be shown 10 new  cases of MRI of all joints as a video test to answer immediately and answered interactively immediately by Prof George.  Radiologists and Non Radiologists will also undergo ultrasound practical test.
 
On Sunday a post test MSK MRI and Ultrasound test will be given to the Radiologists.
 
 
( SELECTED ELECTRONIC POSTERS TO BE AVAILABLE FOR REVIEW BY ALL PARTICIPANTS FROM 12 PM - 2PM THURSDAY TO SATURDAY.)  PLEASE SUBMIT ELECTRONIC POSTERS AND IF ACCEPTED YOU MAY BE ENTITLED BY YOUR UNIVERSITY TO GET A GRANT TO ATTEND THIS COURSE.
 
 
Materials used in the course  : see latest blogs.
 
 
 
 
Synopsis of the lectures and aims of the course  : 
   

Musculoskeletal Ultrasound of the Knee : 

In this lecture there is considerable emphasis on understanding gross anatomy and radiological anatomy of the knee.   This lecture is done  specifically to go into more detail into the terminology and diagnosis of tendinopathy and tendinitis   ,  different types of tendon pathology from partial to complete tears , tendinosis and tenosynovitis .  Emphasis on the detection of tendinosis, bursitis and ligamentous injury . 

Suprapatelllar recess effusion vs synovial thickening diagnosis is emphasised.

In order to appreciate the ultrasound anatomy use of MRI anatomy is used extensively as well as actual video files of MRI cases which correlate with the injuries that are shown in the lectures on ultrasound pathology of the knee.   There is emphasis on the strengths and weaknesses of MRI and ultrasound for the diagnosis of various pathology of the knee .  Research work done in University of Malaya on MRI of cartilage is also included .

 

 

 Ultrasound of the shoulder :

Considerable time is spend on correlation of gross and radiological anatomy correlation to enable better understanding of the ultrasound technique.  Actual ultrasound demonstration during the lecture also helps the participants to understand the various techniques to demonstrate the various rotator cuff muscles.

The emphasis of the this lecture is the the value of ultrasound in diagnosis of partial and full thickness tears of the rotator cuff especially the supraspinatus which may be the cause of weakness of the arms . Considerable time is also spent on the diagnosis of impingement showing various causes by way of plain films,  MRI and ultrasound .

The value of detection of small amounts of fluid in the subdeltoid bursa and how to diagnose this small amount of fluid is emphasised . In addition some interventional techniques such as injection of calcific tendinosis is described.

 

  

Ultrasound of the ankle and foot:

Considerable time is spent to teach gross and radiolgical anatomy correlation

The rest of the time is showing common pathology of the ankle and foot such as  lateral and medial ligament tears especially ATFL , CFL and Anterior tibiofibular ligaments .

In addition lateral and medial and achilles tendon pathology is shown in detail sometimes with MRI correlation .   Tendinosis, tenosynovitis , achilles tendon tendinosis , enthesopathy , partial and complete tears are described on ultrasound.

 

Ultrasound  of the wrist and elbow:

The emphasis of this lecture is the detection of commonly diagnosed pathology including:

1)      De Quervains tenosynovitis

2)      Carpal tunnel syndrome ( recent thesis work by Prof Georges thesis student)

3)      Triangular fibrocartilage tear

4)      Ganglion cysts

5)      Epicondylitis

6)      Collateral ligament tear

7)      Triceps and biceps brachii tears

 

 

Ultrasound of the small joints ( included at the end of lecture on elbow and wrist)

The emphasis now in rheumatology is the detection of synovits , doppler flow and erosions of the joint and the anatomy , pathology and diagnosis by ultrasound of synovitis and its grading is taught in this course .  
 
 
Ultrasound of muscle and tendons:   How to detect and grade muscle tears and diagnose the different tendon pathology on ultrasound.  This lecture is especially for Rehabilitation specialists.
 

PRACTICAL HANDS ON ULTRASOUND :

This is conducted by three radiologists including Professor George and Dr Daniel Makes .  Other visiting trained radiologists assist to teach basic manouveres in Musculoskeletal ultrasound during the year including Dr Paulus Rihardjo who is a very experienced Musculoskeletal Radiologists from Surabaya, Java Island , Indonesia. , Dr Grace Chandra etc.   At least 11/2 to 2 hours is spend with 6 ultrasound machines being made available , which gives an ideal ratio of one tutor to six students and three to four students maximum  to one piece of equipment so that ample time is given for hands on and to ask the supervisors questions.  

 

 

 

FINAL ASSESSMENT :

 

At the end of the course  at POST TEST MCQ is held with same questions as on the first day and scores and tallied and results announced to all participants.

There is a practical test at the last session where each participant is asked to show skills learned to show ultrasound diagnosis or anatomy.  The participants must be able to demonstrate by themselves 3 out of  5 structures taught from any part of the body .  This is a great session to observe once again all the structures and tutors will show and correct each person if they are not able to demonstate the structure to the satisfaction of the examiner.
There is also a short ultrasound video test conducted by Dr Daniel Makes from his extensive collection of ultrasound cases.
 
We are grateful to the Asian Federation of Ultrasound in Medicine (AFUSMB) and now Medical Progress Intitute of Great Britain that has vetted at highest level and given accreditation and giving this unique course international recognition for the quality and content of this course.  This course promotes Musculoskeletal Ultrasound training and as a bonus for Radiologists MRI diagnostic interpretation throughout the course. Next year , the World Federation of Ultrasound is giving the ISUM centre running International Courses the World Centre of Excellence status.
 
You can read how just ordinary general radiologists have remarked how much they have learned in such a short time to improve very much their skills at reporting MSK MRI and doing screening and diagnostic MSK ultrasound on the section named "Comments on the courses" in this website.
 
Only those radiologists who have attended the BASIC course will be invited to join a special advance course where specially selected cases : 30 MRI of Knee, 30 MRI of the shoulder and 30 cases of elbow , wrist and ankle will be discussed interactively for 3and half days.   This will cover all the possible pathology you are likely to encounter and go over the basics of the first course  if needed when you have doubts .  BUT you need to have attended the BASIC course to be allowed on the ADVANCED COURSE.  The first advanced course is likely to be in 2012. 
 
CONFIRMED DATES FOR RADIOLOGIST COURSES ARE in the latest blogs.
 
Please contact Prof Dr John George on msk.rad@gmail to either apply for a course which is not full or put your name for the next available course or for other enquires. Remember places go fast for overseas students as only 4 places are available to overseas Radiologists.  In the last course the four places were taken in just 3 days of opening the course to those on the waiting list who confirmed.
Overseas participants must send their CV to Prof George for approval to attend this course based on your current experience and need for high level intensive teaching which will be useful to your developing country as this is one of the main aims of this course , to help developing country radiologists to become world class Musculoskeletal MRI and Ultrasound exponents through this and future advanced courses and mentorship.
 
Save Bank Charges by sending a combined bank transfer with your friends rather than individually.
 
Best to come in a pair as friends so you have company for shopping  , taxi rides etc.
 
For Indonesia please note:
Bluebird taxis are very safe(guaranteed) and  Hotel Atlet Century http://www.hotelatletcenturypark.com/ (fill in to point of reservation and only then you will be shown special internet rates)  is occupied mainly by locals so it is safe and not targeted by terrorists.  This hotel is in SOUTH JAKARTA and not among the famous American run hotels in Central or upper South Jakarta and hotel and malls in this area have NEVER BEEN TARGETED THUS FAR .
Transport to and from the Training centre is PROVIDED each day at 730 am and return at the end of the course.
  

Yours sincerely ,

 

 

Prof Dr John George

University of Malaya Medical Centre

Kuala Lumpur 59100

Email : msk.rad@gmail.com for any further clarification.

Comments (0) | 12-Nov-09 12:44:43 PM
OUR COURSE MEETS WITH EULAR RECOMMENDATIONS FOR BASIC and INTERMEDIATE RHEUMATOLOGY ULTRASOUND TRAINING

EULAR RECOMMENDATION FOR MUSCULOSKELETAL ULTRASOUND COURSE
 
The only aspect not covered in our course in detail  is in RED FONT . This means that you would have covered BASIC AND INTERMEDIATE REQUIRMENTS AT OUR COURSE BASED ON EULAR RECOMMENDATION>
 
1. MSUS education model. A three level education model with basic, intermediate

and advanced levels will be conducted.

2. Course timing. There will be three level courses with timing and location related

to the annual EULAR Congresses if local organisers are willing and able to

conduct the courses. If future EULAR Congresses take place in cities/countries

where there are no colleagues willing or able to organise the MSUS courses,

another colleague can organise three courses (basic, intermediate and advanced)/

simultaneously in their country/city. With this course timing, 2 years is the

minimum time in which all three courses can be attended by trainees interested in

MSUS. They would have a minimum of 1 year for practising between consecutive

levels.

3. Course curriculum. Basic courses will focus on examination technique and will

include some basic pathology. Intermediate courses will focus on a wide spectrum

of rheumatologic pathology. Advanced courses will focus on current MSUS

research in rheumatology, new technological developments, uncommon

pathological findings in rheumatology, pathological findings in other specialities

such as nerve, ligament, muscle lesions, sport related lesions, and MSUS

methodology (Tables 1, 2 and 3).

 

 

Basic course content

Application, indications and limitations of MSUS in rheumatology.

Ultrasound physics and technology

Sonographic pattern of the different musculoskeletal tissues

MSUS artefacts and pitfalls

Standard sonographic scans of the shoulder, elbow, wrist and hand, hip, knee, ankle

and foot

Holding the probe and optimising the grey-scale settings of the sonographic system

Image documentation

Reporting ultrasound findings and diagnosis

 

Basic course pathologies

Joint synovitis

Joint effusion

Synovial hypertrophy

Bursitis

Tenosynovitis

 

Intermediate course content

Colour and power Doppler physics and technology

Application, indications and limitations of colour and power Doppler in rheumatology

Use of the colour and power Doppler settings

Colour and power Doppler artefacts

Use of colour and power Doppler to detect synovial and entheseal inflammation

Assessment and quantification of structural joint damage (bone, tendons, ligaments)

Sonographic-guided periarticular and articular injections

 

 

Intermediate course pathologies

Joint synovitis, synovial hypertrophy, tenosynovitis

Tendon calcification

Enthesopathy

Tendinosis

Paratenonitis

Tendon subluxation/luxation

Intrasubstance tendon lesions

Tendon impingement

Complete tendon tear

Partial tendon tear

Bone erosions

Osteophytes

Ganglia and cysts

Articular cartilage lesions

Peri- and intra-articular microcrystal deposit

Ligament, muscle, cartilage, fibrocartilage and synovial calcification

 

 

Advanced course content

Optimisation of colour and power Doppler settings

Sonographic-guided musculoskeletal interventional procedures

Assessment and quantification of synovial, tenosynovial and entheseal inflammatory

activity

Role of ultrasound in vasculitis

Evaluation of vessels and detection of vasculitis by sonography

Pediatric sonography: musculoskeletal sonoanatomy and pathological findings in

rheumatic diseases

Uncommon sonographic pathological findings in rheumatology

MSUS technological development

3- and 4-dimensional MSUS

Update on MSUS in rheumatology

MSUS research and methodology

 

 

Advanced course pathologies

Peripheral nerve entrapment and lesions

Ligament lesions

Fibrocartilage lesions

Myopathy

Myositis

Muscle injury

Soft tissue masses

Loose bodies

Foreign bodies

 

 

 

4. Course duration. 20 hours for 3 days.

5. Number of participants per teacher in practical sessions. Ideally 4-5,

maximum 6 participants per teacher.

6. Time spent on hands-on scanning. 50-60% of total time will be spent in practical

training for all courses. 40-50% of total time will be theoretical teaching.( WHICH OUR COURSE HAS)

7. Attendance at the EULAR Ultrasound Courses. There will be no prerequisites

for attending basic courses. Previous performance of > 100 musculoskeletal

ultrasound scans is strongly recommended before participating in an intermediate

level course and previous performance of > 300 musculoskeletal ultrasound scans

is strongly recommended before attending an advanced level course.
(WE WILL TEACH YOU BASIC AND INTERMEDIATE- YOU THEN DO 200 SCANS AND LOG IT on MICROSOFT OR OTHER DATABASE AND SEND TO US AND WE WILL INVITE YOU THE THE ADVANCED COURSE)

8. Certification. ISUM . Asian Federation of Ultrasound in Medicine and Biology and Medical Progress Institute will certify you have done LEVEL BASIC AND INTERMEDIATE ULTRASOUND TRAINING ACCORDING TO EULAR GUIDELINES AND ALSO WHEN YOU HAVE DONE 200 SCANS YOU CAN ATTEND THE ADVANCED COURSE>

Comments (0) | 11-Nov-09 10:42:21 AM