Diplom Muskuloskelettale Radiologie

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Diplom Muskuloskelettale Radiologie

Diplom Muskuloskelettale Radiologie

Das DGMSR Diplom richtet sich an etablierte oder in fortgeschrittener Weiterbildung befindliche Radiologinnsn und Radiologen. Es hat das Ziel, das besondere Interesse und einen überdurchschnittlichen Kenntnisstand auf dem Gebiet der Muskuloskelettalen Radiologie zu dokumentieren und zu beurkunden. Es orientiert sich an den Vorgaben der European Society of Musculoskeletal Radiology (ESSR).

Ein erfolgreich abgeschlossenes ESSR Diplom wird auf Antrag ohne weitere Voraussetzungen als DGMSR Diplom anerkannt.

Qualifikationsdauer

Min. 2 Jahre

Max. 5 Jahre

Voraussetzungen

1. Facharztqualifikation in Radiologie oder in Weiterbildung (Jahr 4 und 5) zum Facharzt / Fachärztin in Radiologie.
Das DGMSR Diplom kann nur prospektiv nach Anmeldung beim Fachausschuss der DGMSR erworben werden.
Zur Anmeldung wird ein unterschriebener, lückenloser Verlauf über die bisherige Weiterbildung bzw. berufliche Laufbahn des Diplomanden benötigt.

2. Erfüllung der Voraussetzungen zur Erteilung des Diploms innerhalb eines maximalen Zeitraums von 5 Jahren
ab dem Tag der Akkreditierung.

3. Vollständige Teilnahme an mindestens 2 Jahrestagungen der DGMSR oder der ESSR

4. Erwerb von mindestens 75 CME Punkten im Ausbildungszeitraum in Refresher- und Weiterbildungskursen auf dem Gebiet der muskuloskelettalen Radiologie, wobei ein Großteil des Spektrums der muskuloskelettalen Radiologie ( s. Gegenstandskatalog) abgedeckt sein sollte.

Gegenstandkatalog der DGMSR (in Bearbeitung)

Das DGMSR-Diplom orientiert sich am Gegenstandskatalog der Europäischen Gesellschaft für Radiologie (siehe www.myesr.org), formuliert von der ESSR (Europäische Gesellschaft für MSK-Radiologie). Es wird als Dokument zur Orientierung angefügt. Ein deutsche Version ist geplant.

Was zeichnet einen Subspezialisten in MSK Radiologie aus? Die ESR hat ein Gesamtkonzept aus „Knowledge, Skills , Competences und Attitudes“ entwickelt. Während „Wissen“ und „Fähigkeiten“ den gängigen Mustern einer Ausbildung folgen, sind „Competences und Attitudes“ vielleicht am besten als „Verständnis und Lösung der jeweiligen medizinischen Situation“ zu übersetzen und einzuordnen.
Wissen (Knowledge)
- To have an in-depth knowledge of the anatomy and physiology of bones and joints (both synovial and non-synovial) of the upper extremities, lower extremities and pelvis
- To have an in-depth knowledge of the anatomy of the axial skeleton (i.e. cervical, thoracic, and lumbosacral spine), intrinsic back muscles and related soft-tissues (e.g. discs, ligaments, spinal nerves)
- To have an in-depth knowledge of the anatomy of the soft-tissue structures that are pertinent to the musculoskeletal system (e.g. tendons, muscles, nerves, ligaments, fascial planes, vessels and connective tissue spaces) in the upper extremity, lower extremity, pelvis, thoracic cage, abdominal wall and neck
- To have a basic knowledge of biomechanics and pathophysiology of the muscle-tendon-bone unit
- To understand the main stages of skeletal maturation in the paediatric age group
- To know the most common anatomical variants in musculoskeletal imaging
- To describe congenital and developmental anomalies of the skeleton and soft-tissue structures that are pertinent to the musculoskeletal system
- To have an in-depth understanding of the clinical and imaging presentations of traumatic injuriesof the axial and appendicular skeleton, including:
  » common and uncommon fractures» common and uncommon dislocations» physiological fracture healing» complications of facture healing including delayed union, malunion and non-union» complex regional pain syndrome
- To understand the basic mechanisms of traumatic injury to the axial and appendicular skeleton
- To understand the di erentiating criteria between stable and unstable injuries
- To have an in-depth understanding of the clinical and imaging presentations of overuse pathologies of the axial and appendicular skeleton, including:
  » labral tears
  » shoulder impingement syndromes
  » overuse tendinopathies and tears
  » retinacula-related disorders
  » exertional compartment syndromes
- To have an in-depth understanding of the clinical and imaging presentations of arthropathies and neurologic/ muscular disorders and connective tissue diseases of the axial and appendicular skeleton, including:
  » rheumatoid arthritis
  » psoriatic arthritis and psoriatic spondyloarthropathy
  » ankylosing spondylitis
  » scleroderma
  » systemic lupus erythematosus
  » mixed connective tissue disease
  » juvenile idiopathic arthritis
  » idiopathic in ammatory myopathy
  » gout
  » crystal-related arthritis
  » neuropathic osteoarthropathy
- To have an in-depth understanding of the clinical and imaging presentations of infectious disorders of the axial and appendicular skeleton, including:
  » Cellulitis
  » Pyomyositis
  » Abscess
  » Septic arthritis
  » diabetic pedal infection
  » HIV-related, atypical mycobacterial infections
- To have an in-depth understanding of the clinical and imaging presentations of metabolic and endocrine diseases of the axial and appendicular skeleton, including:
  » osteoporosis
  » hyperparathyroidism
  » Renal osteodystrophy
  » amyloidosis
  » Gaucher disease
  » storage diseases
  » osteogenesis imperfect
  » Marfan syndrome
  » Paget disease
  » hypertrophic osteoarthropathy
  » sarcoidosis
  » tuberous sclerosis
- To have an in-depth understanding of the clinical and imaging presentations of congenital diseases of the axial and appendicular skeleton, including:
  » flatfoot and clubfoot
  » osteochondrodysplasia
  » failure of growth and development of cartilage and brous tissue
  » anomaly in density and modelling
  » dysostosis
  » chromosomal anomalies
- To have an in-depth understanding of the clinical and imaging presentations of bone and soft-tissue tumours and tumour-like conditions of the axial and appendicular skeleton, including:
  » systematic assessment of a solitary lesion of bone and its categorization as aggressive or nonaggressive
  » appropriate di erential diagnosis based on patient’s age, lesion location and characteristics – boundaries, matrix, periosteal reaction, soft-tissue extension
- To understand a systematic, safe and cost-e ective radiologic work-up of bone lesions, including biopsy approach and compartmental anatomy
- To understand normal postoperative ndings and complications of common orthopaedic procedures and hardware placement, including ndings of loosening and infection of orthopaedic hardware
- To know the clinical and imaging presentations of skeletal and soft-tissue injuries (including sports injuries, skeletal manifestations of child abuse), common congenital syndromes and clinically relevant developmental dysplasias (e.g. focal growth disturbances, DDH, coalitions, dysplasias, irritable hip, spinal deformity) in the paediatric age group
- To have a detailed knowledge of interventional musculoskeletal procedures, including interventions of the spine such as discography, nerve root injections, epidural injections, facet/SI joint injections, vertebroplasty, kyphoplasty
- To understand the role of nuclear medicine and densitometry techniques in the musculoskeletal system
- To have an in-depth knowledge of MRI safety issues as they pertain to musculoskeletal imaging (incl. Gadolinium-related concerns such as nephrogenic systemic brosis / NSF)
- To understand the potential impact of technologic development and last results of research on musculoskeletal imaging practice
Fähigkeiten (Skills)
- To define skeletal age and to recognize appropriate/abnormal skeletal growth
- To recognize differences between normal variants and pathology
- To confidently differentiate stable and unstable traumatic injuries of the skeleton
- To recommend appropriate imaging of common and uncommon musculoskeletal conditions as subspecialty expert
- To perform/supervise and interpret all imaging techniques and procedures relevant to the investigation and management of musculoskeletal diseases to high standard
- To maintain a log of all procedures performed including complications
- To perform a basic physical examinations of the musculoskeletal system prior to imaging
- To evaluate a standard two-view radiographic examination to respect all quality items
- To guide the technician in performing additional views, suggesting optimal patient’s positioning
- To supervise the imaging quality of radiograms performed by technicians showing how to obtain good views also in challenging situations (e.g. in multitrauma patients)
- To perform (and/or guide the technician in performing) ultrasound examination of the upper (i.e. shoulder, arm, elbow, forearm, wrist and hand) and lower (i.e. hip, thigh, knee, leg, ankle and foot) extremities and to diagnose the most common pathologic conditions in these areas
- To perform basic ultrasound (and/or guide the technician in performing) examination of the neck, thoracic cage and abdominal wall
- To confidently plan and supervise a CT examination in musculoskeletal radiology and to tailor it to the individual situation with a dose as low as reasonably achievable
- To perform (and/or guide the technician in performing) post-processing of musculoskeletal CT examinations, with appropriate rendering and MPR and MIP reconstructions
- To confidently perform (and/or guide the technician in performing) a standard MR imaging examination of the upper and lower extremities, thoracic cage, abdominal wall, pelvis and neck (as pertinent to musculoskeletal radiology) respecting all quality items and tailor it to the individual patient situation in regard to spatial and contrast resolution and to the potential use of intravenous contrast medium administration
- To perform (and/or guide the technician in performing) post-processing of musculoskeletal MR imaging examinations, including temporal subtraction of dynamic contrast-enhanced studies, region-of-interest based dynamic analyses and calculation of apparent di usion coe cient from DWI acquisitions
- To perform placement of needles into di erent joints using uoroscopy or ultrasound as a guidance without supervision
- To confidently perform and interpret an arthrogram (combined with uoroscopy, CT or MRI) without supervision
- To manage potential complications (including post-procedural infection)
- To use sterile preparation techniques throughout all procedures in musculoskeletal interventions
- To safely plan and execute both small and large joint injections without supervision
- To choose the best biopsy system and the best technique for biopsy guidance for musculoskeletal indications, taking into account patient comfort and cost-e ectiveness principles
- To manage common intra- and post-procedural complications in musculoskeletal interventions
- To accurately and safely perform ultrasound-guided/CT-guided procedures on joints and soft-tissue
- To perform image-guided biopsies of bone and soft-tissue masses
- To safely perform image-guided drainage procedures of abscesses, haematomas and serous collections in the musculoskeletal system
- To perform and present research related work related to scienti c questions and or evidence based improvement and quality work in the eld of musculoskeletal radiology
- To critically review the literature and research articles in the eld
- To conduct a research study, and to evaluate and present the results in a scienti c manner
- To understand the potential impact of technological development and learn how to translate results of research into clinical practice
Kompentenzen und Haltung (Compentences und Attitudes)
- To require minimal supervision from senior colleagues in the routine musculoskeletal imaging work- ow
- To select the optimal imaging method for imaging disorders of the musculoskeletal system according to the clinical problem and justify the use of diagnostic imaging examinations and/or interventional procedures
- To choose the best-suited method to address speci c clinical questions in musculoskeletal radiology according to current guidelines
- To communicate with the patient and to obtain informed consent prior to musculoskeletal imaging
- To describe and explain the nature of potentially complex radiological tests/procedures in musculoskeletal imaging to patients and, where necessary, clinical colleagues
- To choose optimal protocols for radiographic, CT and MRI examinations of the musculoskeletal system
- To create and apply protocols and standard operating procedures to reduce exposure doses for radiological examinations in musculoskeletal radiology
- To supervise and teach technical sta to ensure that appropriate images are obtained for all radiological methods in musculoskeletal radiology
- To judge the quality of imaging examinations in musculoskeletal radiology and to devise strategies to maintain high quality standards
- To link clinical presentations and radiological ndings in musculoskeletal imaging with likely diagnosis or, at least, reasoned di erential diagnoses
- To construct a concise, informative radiology report in musculoskeletal imaging with, where appropriate, recommendations for further radiological tests
- To con dently interpret and report CT, MRI and radiographic examinations of the musculoskeletal system
- To discuss radiological ndings in orthopaedic medicine with referring physicians at peer level
- To con dently lead the radiological aspects of multidisciplinary team meetings in musculoskeletal imaging
- To be able to discuss both routine and more complex musculoskeletal imaging cases with radiology colleagues, referring clinicians and patients, also explaining the level of uncertainty of particular cases
- To appreciate and respect the roles and work of other non-medical personnel (including radiographers, nurses, support sta , secretaries etc.) in the musculoskeletal imaging unit and communicate with them in a professional manner
- To actively and positively interact with the other specialists of the multidisciplinary musculoskeletal team (such as orthopaedic surgeons, rheumatologists, physical therapists etc.), being an integrated member of the team in planning diagnostic studies, therapies and in outcome review
- To prioritise radiological work- ow in musculoskeletal imaging as based on clinical urgency
- To identify urgent and/or unexpected ndings in imaging examinations of the musculoskeletal system and
  to communicate these timely and properly
- To identify complex cases in musculoskeletal imaging, in which it is appropriate to obtain a second opinion
  for interpreting and reporting
- To retrieve current information on state-of-the art procedures in musculoskeletal imaging such as guidelines from national and international societies
- To continuously keep abreast of the key recent publications in the eld of orthopaedic medicine, pathology and radiology
- To have audit and research skills in musculoskeletal imaging
- To present ndings and lecture at meetings relevant to musculoskeletal imaging
- To teach musculoskeletal imaging
- To participate in discussions with other sta regarding operational challenges and potential system solutions regarding the work ow and other aspects of the musculoskeletal radiology service

Die dazu geeigneten Kurse (z.B. DGMSR-Refresherkurse, Augsburg-Münchner Seminare, Osteoradiologisches Seminar Bremen, Kurse in Neuss, Davos, ESSR-/ISS-Kongresse, ECR-Refresherkurse, usw.) werden auf der Homepage der DGMSR bekanntgegeben. Sie sind ausdrücklich mit „für Qualifikation der DGMSR geeignet“ gekennzeichnet.

Für eine Zeitschriftenpublikation (als Erst- oder Letztautor indexiert in pubmed) bzw. einen Tagungs-Abstrakt (auf Kongressen der DGMSR, ESSR, ISS) innerhalb der Qualifizierungsphase werden 10 bzw. 5 CME-Punkte anerkannt.

5. Erfolgreiche Absolvierung einer Prüfung (40 Minuten multiple choice, 20 Minuten mündlich).
Ein Unkostenbeitrag von 150,- Euro wird vor der Teilnahme an der Prüfung erhoben.
Die Teilnahme an der Prüfung ist jederzeit möglich, frühestens nach bestandener Facharztprüfung.
Termine werden regelmäßig angeboten.

6. Die Urkunde wird nach bestandener Prüfung und Vorlage der Nachweise der im Ausbildungszeitraum erworbenen CME-Punkte ausgestellt.

Dokumente:

Antrag für das DIPLOM der DGMSR (PDF)

Hinweis: Bitte nur einreichen, wenn Sie alle erforderlichen Nachweise Ihrer erfolgreichen Teilnahme am Diplomprogramm beilegen können.