Sandra J. Allison MD, Presenter: Nothing to Disclose

Levon N. Nazarian MD, Abstract Co-Author: Nothing to Disclose

Laurence Parker PhD, Abstract Co-Author: Nothing to Disclose

Musculoskeletal sonography (MSK US) has recently been growing in popularity as an imaging modality. Our purpose was to investigate radiologists' attitudes toward MSK US and MRI.

A web-based survey was sent by e-mail to 300 members ofthe Society of Skeletal Radiology and 105 members of the Society of Radiologists in Ultrasound. The survey consisted of multiple choice and 3 to 5 point preference questions about attitudes toward MSK imaging. Mann Whitney U tests were computed to test differences in the preference score between MSK radiologists and sonologists.

The response rate of the survey was 27.4% (111 surveys): 84 MSK radiologists; 22 sonologists; 4 general radiologists; and, 1 "other". The sample was 75.6% (n=84) male and 24.4% (n=27) female. Physician experience ranged from 1 to 51 years (mean= 13.1; sd=9.3). Only 20.7% (23/111) believed that US should be the first cross-sectional modality for evaluating injuries to tendons, ligaments, and muscles, while 77.5% (86/111) believed MRI should be first. However, 59.2% (61/103) thought that too few MSK US were ordered, as compared to 21.2% (22/104) too few MRIs. Respondents indicated a number of negative attitudes and opinions of MSK US: 82.5% (80/97) felt reimbursement was too low; 68.9% (71/103) felt that referring physicians' interest was too low; 69.4% (75/108)reported that their MSK US training was inadequate; and, 66.7% (70/105) felt that MSK US required too much physician time. Respondents who do not perform MSK US cited extensive time involvement, operator dependence and lack of formal training as top reasons. MSK radiologists showed more (mean= 4.2 vs. 3.3 out of 5, p <.005) agreement than sonologists with the statement that MRI should be the first cross-sectional MSK imaging test, and less agreement (2.2 vs. 3.5, p <.0001) with the statement that US should be the first test.

Our survey results demonstrated that radiologists think MSK US is currently underutilized as an imaging modality. Radiologists cite inadequate training, low reimbursement rate, and large physician time as reasons. Sonologists were more likely to favor US, and MSK radiologists were more likely to favor MRI.

Allison, S, Nazarian, L, Parker, L, Survey of Radiologists’ Attitudes toward Musculoskeletal Sonography and MR Imaging.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415595.html