AB1190 Ultrasonography in spainsh rheumatology: a cross sectional survey

Background Ultrasonography (US) is the rheumatologists’ best tool that must be taught and learnt correctly. The ultrasound school of the Spanish Society of Rheumatology has trained many rheumatologists for more than twenty years. Approximately 75% of the rheumatology departments in Spain use US. However, we lack current views of features related with competency, teaching rheumatology residents, US usage and implementation. Methods A cross sectional survey was performed using an online standardised questionnaire sent to all members of the SSR in January 2017. The questionnaire was developed by the four authors, corrected for size, style, syntaxes and was piloted on four different aged rheumatologists. Six aspects were studied; general data, US training, rheumatology residents training in US and main uses and applications of US. The questionnaire used either closed or Likert scale answers and took about 20 min to answer. Herein we describe the main results on usage and applications of US. Results 113 responses: 60% women, 45±12 years old, 73% working in public university hospital with one or more US machines. US is usually used at the time of clinical consultation or at appointment for US. 43% have a specific agenda for US diagnosis and monitoring inflammatory arthritis patients. The 3 principals for using US are: as a problem solving tool in the clinical context; as a diagnostic tool in inflammatory arthritis and; as a tool to guide injections. The table shows the percentage of the responses always and almost always for 10 clinical contexts. As diagnostic tool in rheumatoid arthritis (RA), 66% use US to confirm arthritis when clinical exam is unclear and 33% in patients with inflammatory arthralgia plus high ESR, CRP, RF or anti-CCP. 36% monitor disease activity using a reduced joint assessment; one target joint plus 2,3 MCP and 2,3, 5 MTP joints and 32% use a validated joint count. 66% use US to assess remission in RA all patients (22%), only in those treated with biologic drugs (28%) and in RA patients with poor prognostic factors (18%). Most use US to confirm clinical enthesitis when a spondyloarthropathy (SpA) is suspected and half consider that a positive entheseal Dopppler signal supports more aggressive management. 76% perform real-time guided injections for the following disorders/sites: Baker’s cyst, subacromial-subdeltoid bursa, tibionavicular joint, anterior coxofemoral joint, retrocalanceal bursa and extensor wrist tenosinovitis. Conclusions Rheumatologist- ultrasonographers in Spain use ultrasonography in a wide spectrum of diseases and clinical contexts mainly to facilitate diagnosis and improve treatment of rheumatic patients. Disclosure of Interest None declared