For diagnosis and treatment of rheumatic disease
Amy Cannella, M.D., internal medicine-rheumatology, is one of the first people in the U.S. to use musculoskeletal ultrasound (MSUS) for the diagnosis and treatment of rheumatic disease. She was in the first cohort to take the certification exam and received her certification in May 2013.
Dr. Cannella said MSUS is routinely used to detect joint synovitis and effusion and assess response to therapy. It also can be used to facilitate joint injections, particularly in deep joints, such as the hips and for routine joints, such as the knee, when due to patient size or previous joint damage normal anatomical landmarks are not sufficient.
The dynamic nature of the procedure and ability to compare contralateral structures makes MSUS particularly suited to look at tendon pathology, and it is increasingly used to diagnose entrapment neuropathies, such as carpal tunnel syndrome. In some cases, it can eliminate the need for additional testing, saving patients money.
Dr. Cannella also is a mentor for the Ultrasound School of North American Rheumatologists (USSONAR), which provides an online, interactive teaching site and hands-on workshops for fellows from around the country.
Teaching is an important part of Dr. Cannella’s job. She is the Rheumatology Fellowship director and has incorporated MSUS into the curriculum. She also teaches MSUS at national courses.
With a group of ultrasound educators in rheumatology, Dr. Cannella is developing a standardized MSUS curriculum and assessment tools for fellows in rheumatology training, in accordance with the Next Accreditation System.
She coauthored an article on best practices in MSUS, which was published in the January issue of Arthritis Care & Rheumatism.
In addition to Dr. Cannella, Michelene Hearth-Holmes, M.D., received her RhMSUS certification in November and Annika Cutinha, M.D., also does MSUS. Dr. Hearth-Holmes runs an ultrasound clinic at the VA Medical Center. All three physicians have ultrasound clinics at UNMC.
Dr. Cannella said the fellows learn this modality quickly and frequently use it on the inpatient service. Physicians wanting to refer patients for MSUS can contact the rheumatology division at 402-559-7288.