15 th EULAR SONOGRAPHY COURSE. June 08 th - 11 th, 2008 Paris, France. Basic, Intermediate and Advanced Musculoskeletal Ultrasound in Rheumatology

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1 15 th EULAR SONOGRAPHY COURSE Basic, Intermediate and Advanced Musculoskeletal Ultrasound in Rheumatology June 08 th - 11 th, 2008 Paris, France Societé française de rhumatologie Université de Versailles Saint-Quentin-en-Yvelines

2 ORGANIZATION AND COMMITTEE GENERAL INFORMATION Societé française de rhumatologie President Prof. Hans Bijlsma Chairman of the EULAR Standing Committee for Education and Training Dr. Maria Antonietta D Agostino EULAR Working Group for Musculoskeletal Ultrasound Faculty Marina Backhaus, Germany - Peter Balint, Hungary - Hilde Berner Hammer, Norway J. Antonio Bouffard, USA - Jean Louis Brasseur, France - George Bruyn, The Netherlands Isabelle Chary-Valckenaere, France - Paz Collado, Spain - Maria Antonietta D Agostino, France Eugenio De Miguel, Spain - Fabien Etchepare, France - Emilio Filippucci, Italy - Philippe Gaudin, France Walter Grassi, Italy - Annamaria Iagnocco, Italy - Sandrine Jousse-Joulin, France - David Kane, Ireland Andrea Klauser, Austria - Nathalie Klemmer, France - Juhani Martti Koski, Finland Bertrand Lecocq, France - Damien Loeuille, France - Carlo Martinoli, Italy - Ingrid Möller, Spain Bertrand Moura, France - Esperanza Naredo, Spain - Alexander Scheel, Germany Wolfgang Schmidt, Germany - Nanno Swen, The Netherlands - Marcin Szkudlarek, Denmark Lene Terslev, Denmark - Jacqueline Uson, Spain - Donato Vassalli, Italy Richard J. Wakefield, United Kingdom Hands on tutors Marco Maria Lizzio, Italy - Carlos Pineda, México Université de Versailles Saint-Quentin-en-Yvelines Course opening Sunday, June 08 h, 2008 h Course closing Wednesday, June 11 th, 2008 h Participants 105. The number of participants is limited to 35 per each course Official language English Congress venue Courtyard by Marriott **** Paris - Charles de Gaulle Airport Zone Hoteliere - Allée du Verger Roissy en France - France Scientific Organizers Maria Antonietta D Agostino Paris Ile-de-France-Ouest UVSQ Service de Rhumatologie Hôpital Ambroise Paré 9, avenue Charles de Gaulle Boulogne-Billancourt - France maria-antonietta.dagostino@apr.aphp.fr Sandrine Jousse-Joulin Service de Rhumatologie CHU La Cavale Blanche Bvd Tanguy Prigent Brest - France sandrine.jousse-joulin@chu-brest.fr Organizing Secretariat EDRA Spa Viale Monza, Milano - Italy Phone: Fax: Stefania Livesu s.livesu@edraspa.it Website SFR - Societé française de rhumatologie European League Against Rheumatism The 15 th EULAR Sonography Course: [ Basic ] [ Intermediate ] [ Advanced ] Musculoskeletal Ultrasound in Rheumatology consists of three simultaneous courses, basic, intermediate and advanced, each of them being a combination of lectures (25% of total time in the basic and intermediate courses and 50% in the advanced course) and supervised hands-on scanning of models and/or patients with musculoskeletal disorders (75% of total time in the basic and intermediate courses and 50% in the advanced course). 2 3

3 OBJECTIVES - To know and identify normal muscoloskeletal sonoanatomy - To learn the systematic standardised sonographic scanning method of each anatomical region, according to the EULAR guidelines - To know the basic pathological sonographic findings - To perform sonographic-guided injections [ Basic Course ] MAIN TOPICS - Applications, indications and limitations of MSUS in rheumatology - Role of MSUS in rheumatological clinical practice - Musculoskeletal sonoanatomy - Artifacts and misinterpretation in MSUS - Standardised sonographic scanning method of each anatomical region (shoulder, elbow, wrist and hand, hip, knee, ankle and foot), according to the Eular guidelines - Basic pathological sonographic findings (tendinosis, tenosynovitis, partial and complete tendon tear, enthesopathy, bursitis, cortical abnormalities, calcifications, articular cartilage lesions, and joint synovitis) in each anatomical region (shoulder, elbow, wrist and hand, hip, knee, ankle and foot) - Ultrasound physics and technology - Education and training in MSUS - Reliability of MSUS - Technical characteristics of ultrasound equipments for rheumatology Basic course is recommended for participants with little or no experience in MSUS WORKSHOP - Practical handling of the ultrasound machine settings - Supervised identification of musculoskeletal sonoanatomy - Supervised standardised sonographic scanning of the shoulder, elbow, wrist and hand, hip, knee, ankle and foot - Supervised hands-on scanning of patients with basic musculoskeletal lesions 4 5

4 SCIENTIFIC PROGRAMME Sunday, June 08 th, 2008 Monday, June 09 th, Registration Welcome Chairman: E. Naredo History and physics of musculoskeletal ultrasound (MSUS). Artefacts, technical limitations and misinterpretation in MSUS G. Bruyn Basic sonoanatomy (muscle, tendons, bursae, ligaments, nerves, cartilage, joint space, joint recesses, joint capsules, and bone profile). Correlation between anatomy and sonographic images P. Balint Sonographic semiology (tendinosis, tenosynovitis, partial and complete tendon tear, enthesopathy, bursitis, cortical abnormalities, calcifications, articular cartilage lesions, effusion and joint synovitis) N. Klemmer Chairmen: I. Chary-Valckenaere, C. Martinoli Basic US pathologies. Correlation between clinical and sonographic findings D. Kane Workshop > Supervised practical handling of the ultrasound machine settings. Normal musculoskeletal sonoanatomy (muscle, tendons, bursae, ligaments, nerves, articular cartilage, joint space, joint recesses, joint capsules, and bone profile) Chairmen: E. De Miguel, S. Jousse-Joulin Standardised scanning of the knee. Normal and basic pathological findings I. Moller Workshop > Supervised scanning technique of normal knee. How to scan patient and how to obtain images Chairmen: M. Backhaus, P. Collado Standardised scanning of nerves B. Lecoq Standardised scanning of the elbow. Normal and basic pathological findings F. Etchepare Workshop > Supervised scanning technique of normal elbow and nerves. How to scan patient and how to obtain images Lunch Chairmen: N. Klemmer, W. Schmidt Standardised scanning of the wrist and hand. Normal and basic pathological findings H. Berner Hammer Workshop > Supervised scanning technique of normal wrist and hand. How to scan patient and how to obtain images Chairmen: B. Lecoq, N. Swen How to detect normal vascularization of joint L. Terslev Standardised scanning of hip. Normal and basic pathological findings P. Gaudin 6 7

5 Workshop > Supervised scanning technique of hip. How to scan patient and how to obtain images Workshop > Supervised scanning technique of pathological lesions of joints of the legs. How to scan patient and how to obtain images Tuesday, June 10 th, 2008 Wednesday, June 11 th, 2008 Chairmen: J.A. Bouffard, J. Uson Standardised scanning of normal shoulder. Basic pathological findings W. Schmidt Workshop > Standardised scanning technique of the shoulder. How to scan patient and how to obtain images Coffee break Chairmen: F. Etchepare, R.J. Wakefield Standardised scanning of the ankle and foot. Basic pathological findings B. Moura Workshop > Supervised standardised scanning of normal ankle and foot. How to scan patient and how to obtain images Lunch Chairmen: E. Filippucci, B. Moura Standardised scanning of inflammatory and degenerative joint pathologies of upper arm I. Chary-Valckenaere Chairmen: E. Filippucci, P. Gaudin Education and training in MSUS. How can do it E. Naredo MSUS in rheumatological practice: dream or reality? W. Grassi Current and future technical characteristics of ultrasound equipments appropriate for rheumatological studies J. Uson Validity of MSUS A. Scheel Chairmen: W. Schmidt, L. Terslev Evaluation of produced images and test of competency Closing Remarks Workshop > Supervised scanning technique of pathological lesions of joints of the upper arm. How to scan patient and how to obtain images Chairmen: P. Balint, A. Klauser Standardised scanning of inflammatory and degenerative joint pathologies of legs D. Loeuille 8 9

6 OBJECTIVES [ Intermediate Course ] - To describe, identify and demonstrate the principal periarticular and intra-articular pathological sonographic finding in each anatomical region - To review the systematic standardised sonographic scanning method of each anatomical region, according to the EULAR guidelines - Applications, indications and limitations of colour and power Doppler in rheumatology: use of the colour and power Doppler settings for detecting articular and periarticular inflammation; colour and power Doppler artefacts - To perform sonographic-guided injections - To assess, quantify and/or score joint lesions - To understand the role of MSUS in clinical and research practice MAIN TOPICS - Pathological sonographic findings in each anatomical region (shoulder, elbow, wrist and hand, hip, knee, ankle and foot) - Musculoskeletal colour and power Doppler technique - Sonographic-guided musculoskeletal injections - Reliability of MSUS - Sonographic microscopy - Technical characteristics of ultrasound equipments for Rheumatology - Ultrasound physics and thecnology Intermediate course is recommended for participants with some experience in MSUS WORKSHOP - Practical handling of the colour and power Doppler machine settings - Supervised standardised sonographic scanning of the shoulder, elbow, wrist and hand, hip, knee, ankle and foot - Supervised hands-on scanning of patients with musculoskeletal lesions in each anatomical region (shoulder, elbow, wrist and hand, hip, knee, ankle and foot) 10 11

7 SCIENTIFIC PROGRAMME Sunday, June 08 th, 2008 Monday, June 09 th, Registration Welcome Chairman: M. Szkudlarek Current and future technical characteristics of ultrasound equipments appropriate for rheumatological studies A. Iagnocco Workshop > Supervised practical handling of the ultrasound machine settings and correct acquisition of musculoskeletal (MS) sonoanatomy (muscle, tendons, bursae, and ligaments, nerves, articular cartilage, joint space, joint recesses, joint capsules, and bone profile) Chairmen: G. Bruyn, L. Terslev Doppler techniques. Physics, technical principles and practical role in Rheumatology W. Schmidt Colour Doppler and power Doppler. Correlating ultrasound imaging with histopathological findings J.M. Koski Workshop > Supervised practical handling of the colour and power Doppler ultrasound machine settings Chairmen: A. Iagnocco, W. Schmidt Basic US lesions: Synovitis. Definition, detection and quantification R.J. Wakefield Basic US lesions: Erosions. Definition, detection and quantification E. Filippucci Basic US lesions: Bone abnormalities (fractures, osteomyelitis, and prosthesis) J.A. Bouffard Basic US lesions: Cartilage. Definition, detection and quantification E. Filippucci Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative joint disorders. How to detect and quantify synovitis, erosions, cartilage and bone lesions Lunch Chairmen: J.L. Brasseur, A. Klauser Basic US lesions: Tendinopathies and tenosynovitis. Definition, detection and quantification N. Swen Basic US lesions: Enthesitis and enthesopathy. Definition, detection and quantification E. De Miguel Basic US lesions: Muscle (traumatic and inflammatory lesions). Definition, detection and quantification D. Vassalli Basic US lesions: Ligaments. Definition, detection and quantification R.J. Wakefield 12 13

8 Chairmen: M. Backhaus, A. Iagnocco Basic US lesions: Nerves. Definition, detection and quantification. What it is important for rheumatologists J.A. Bouffard Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative joint disorders. How to detect and quantify tendons, enthesis, nerves and muscle lesions Tuesday, June 10 th, 2008 Chairmen: G. Bruyn, I. Moller Standardised scanning of the inflammatory and degenerative (or traumatic) shoulder C. Martinoli, E. Naredo Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative shoulder disorders Chairmen: F. Etchepare, D. Kane Standardised scanning of the inflammatory and degenerative elbow, hip and knee A. Iagnocco Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative knee, hip and elbow disorders Lunch Chairmen: P. Balint; A. Scheel Standardised scanning of pathological hand and wrist M. Szkudlarek Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative hand and wrist disorders Chairmen: I. Moller, M. Szkudlarek Standardised scanning of pathological ankle and foot P. Balint Chairmen: J. Uson, R.J. Wakefield Role of US in the diagnosis of metabolic arthritis: gout and CPPD E. Filippucci Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative, ankle and foot disorders Workshop > Supervised hands-on scanning of patients with metabolic and degenerative disorders Wednesday, June 11 th, 2008 Chairmen: P. Balint, D. Loeuille Sonographic-guided injections and biopsies in rheumatological diseases J.M. Koski Efficacy of sonographic-guided injections D. Kane Workshop > Supervised sonographic-guided injections Chairmen: S. Jousse-Joulin, D. Kane Global evaluation of inflammatory arthritis (bone, synovial and tendon involvement) in daily practice. The role of US in comparison with others imaging techniques M. Backhaus Reliability of MSUS M.A. D Agostino Evaluation of competency Closing Remarks 14 15

9 OBJECTIVES - To diagnose rheumatologic, traumatic and sport tendon lesions by sonography - To diagnose ligament and peripheral nerve lesions by sonography - To assess joint inflammatory activity and structural damage by grey-scale and power Doppler sonography - To discuss difficult issues and emerging research fields in MSUS with experts - To know the role of MSUS in pediatrics - To know the role of MSUS in vasculitis and autoimmune diseases - To know MSUS technological development (3-D, contrast enhanced) [ Advanced Course ] MAIN TOPICS - Sonographic diagnosis of inflammatory, degenerative and traumatic tendon lesions - Sonographic diagnosis of ligament and peripheral nerve lesions - Sonographic assessment of joint inflammatory activity and structural damage in rheumatological diseases - Method for assessing and quantifying synovial and enthesis vascularization: contrast enhanced sonography - Role of sonography in vasculitis - Role of sonography in Sjögren Syndrome - Validity, reproducibility and sensitivity to change of MSUS - Pediatric sonography - Role of 3-D sonography Advanced course is recommended for participants with considerable experience in MSUS WORKSHOP - Supervised hands-on scanning of patients with tendon, ligament and peripheral nerve lesions - Supervised grey-scale and Doppler assessment of patients with inflammatory joint diseases and vasculitis - Supervised use of contrast enhanced sonography on phantom - Supervised use and analysis of 3-D sonography 16 17

10 SCIENTIFIC PROGRAMME Sunday, June 08 th, 2008 Monday, June 09 th, Registration Welcome Chairman: W. Grassi Sonographic diagnosis of traumatic and sport tendon lesions (tendinosis, tenosynovitis, enthesitis, partial and complete tendon tear, tendon luxation) C. Martinoli Validity and reliability of sonographic diagnosis of inflammatory and traumatic ligament and tendon lesions J.L. Brasseur Chairmen: H. Berner-Hemmer, D. Vassalli Role of US in the diagnosis of metabolic arthritis: gout and CPPD E. Filippucci Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative tendon lesions Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative ligament lesions Chairmen: E. Naredo, N. Swen Sonographic diagnosis of peripheral nerve lesions C. Martinoli Sonographic diagnosis of muscle inflammatory and traumatic lesions. Comparison with other imaging techniques D. Vassalli Validity and reliability of sonography in the diagnosis of inflammatory and traumatic nerves and muscles pathology. Comparison with other imaging techniques J.L. Brasseur Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative nerves lesions Workshop > Supervised hands-on scanning of patients with inflammatory and degenerative muscles lesions Lunch Chairmen: M. Backhaus, J.M. Koski Global sonographic assessment of joint disease (inflammatory activity and structural damage) with grey-scale and Doppler sonography E. Naredo Semiquantitative method for assessing synovial vascularity M. Szkudlarek Quantitative methods for assessing synovial vascularity L. Terslev Grey scale and coulour-power Doppler for assessing enthesal inflammation M.A. D Agostino 18 19

11 Chairmen: E. Filippucci, C. Martinoli Role of sonography in vasculitis W. Schmidt Workshop > Supervised hands-on grey-scale and power Doppler assessment of patients with inflammatory joint and enthesis diseases Workshop > Supervised hands-on grey-scale and power Doppler assessment of patients with vasculitis Chairmen: M.A. D Agostino, W. Schmidt Future development of sonography. 3-dimensional MSUS W. Grassi Workshop > Supervised hands-on 3-dimensional MSUS. Assessment of patients with inflammatory joint and enthesis diseases Tuesday, June 10 th, 2008 Chairmen: W. Grassi, D. Kane Sonography of salivary gland in patients with Sjögren Syndrome S. Jousse-Joulin Contrast enhanced sonography. Role and validity in rheumatic diseases A. Klauser Contrast enhanced sonography for detecting sacroiliac joint inflammation A. Klauser Contrast enhanced sonography for detecting and quantifying synovial inflammation M. Backhaus Workshop > Supervised hands-on use of contrast enhanced sonography on phantom Lunch Wednesday, June 11 th, 2008 Chairmen: I. Moller; R.J. Wakefield Pediatric sonography, normal sonoanatomy and standardised scanning. S. Jousse-Joulin Pediatric pathological sonography P. Collado Microscopic sonography. Can we use MSUS for diagnosis? Comparison with gold standards W. Grassi Workshop > Supervised hands-on scanning of patients with degenerative and metabolic joint lesions Evaluation of competency Closing Remarks Workshop > Supervised hands-on grey-scale and power Doppler assessment of salivary glands in patients with Sjogren syndrome Chairmen: M.A. D Agostino, A. Iagnocco How to use sonography as a research tool in rheumatology. Validity, reproducibility and sensitivity to change of MSUS R.J. Wakefield 20 21

12 HOW TO REACH THE CONGRESS VENUE NOTE Congress venue Courtyard by Marriott **** Paris - Charles de Gaulle Airport Zone Hoteliere - Allée du Verger Roissy en France - France Parking - On-site parking, fee: 3 per hour, 13 daily - Off-site parking; contact hotel for details Area Airports Paris/Charles De Gaulle - CDG Phone: Hotel Direction: 2 NW Driving Directions: A1 direction Paris, exit Roissy en France. At the round about take first exit right and directly right again. Follow the street for 500 meters. - Airport shuttle service, on request, fee: 5 (one way) - Estimated taxi fare: 20,00 (one way) - Airport shuttle service, fee: 15 (one way) - Bus service, fee: 23,0 (one way) - Subway service, fee: 15,00 (one way) - Estimated taxi fare: 75,00 (one way) Other Transportation Bus Station - Airport Terminal I - Shuttle service, for a fee Subway Station - Terminal 1 Train Station - Terminal 2 - Shuttle service, for a fee Paris/Orly - ORY Phone: Hotel Direction: 35 N Driving Directions: A86 direction Creteil, Thiais, Vitry. Then A4 direction Bobigny, Lille and after A86 direction Bobigny; Lille. After 8km A3 direction Charles de Gaulle, Lille. 9km later A1 direction Charles de Gaulle, Lille. Follow the sign Charles de Gaulle, Senlis, Louvres. Into the round about. Take the third exit direction Roissy en France. On the traffic light turn to the right. In the following round about, take the third exit again and immediately after turn to your right. Follow the street for 500 meters

13 15 th EULAR SONOGRAPHY COURSE