A three-stage consensus study (nominal group technique, modified Delphi, and structured focus group) involving 13 MSUS experts and 5 non-expert stakeholders aimed to define core musculoskeletal ultrasound (MSUS) competencies for Canadian rheumatology residency training.
Consensus (>70% agreement) was reached on 42 core and 38 optional MSUS items, organized into 33 competencies covering general ultrasound skills, inflammatory arthritis features in hands/wrists/MTP joints, double contour sign (MTP), and effusion detection in knee and ankle joints.
Representation was limited to 7 of 12 English-stream Canadian rheumatology programs, with only 2 U.S. experts; French-stream programs were excluded. Consensus thresholds (>70%) are convention-based and may not reflect true clinical importance.
Program directors can use these 33 MSUS competencies as a ready-made framework to build or standardize MSUS curricula in rheumatology residency. Focus initial training on inflammatory arthritis imaging of hands, wrists, and MTP joints, plus effusion detection in knee and ankle.
