Issue 02 2020

EFSUMB Newsletter

European Federation of Societies for Ultrasound in Medicine and Biology

EFSUMB website From the 31st January 2020 EFSUMB closed some of the sections of the www.efsumb.org web site to public access. These restricted areas of the web site are now available for Members Only access. We are doing this to make sure we are providing great member benefits for all paying EFSUMB members and the National Societies who pay for their members to be part of EFSUMB. Whether you are based in Europe or not EFSUMB are now inviting membership from across the world. Membership options are available for individual members, students, those from low income countries and affiliate memberships.

If you are a member of your own countries National Society then it is likely you are already an EFSUMB member. Check the map below

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You can also check the web page ‘Are you already a Member?’ at http://www.efsumb.org/blog/membership-membercountry If you are not part of a National Society then you can become an individual member from as little as 25 EURO a year or if you are a student 25 EURO for 3 years.

As an individual member you will have exactly the same EFSUMB benefits as National Society members.

Individual members have 2 options for membership. Single year (standard and low-income country) or 5 year membership.

Individual membership sign up page can be found here: http://www.efsumb.org/blog/membership-single Student membership sign up page can be found here: http://www.efsumb.org/blog/membership-student

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Once you have signed up for membership, paid via our secure PayPal server and we have received your application, we will email you with your EFSUMB Member Certificate and Log in Details to log in for all members only content.

You can visit any page on the website to log in – the log in box is on the right-hand side bar of the web site:

You can also go directly to the Log In page at http://www.efsumb.org/blog/membership-login

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If you do not log in, when you try to access any Members Only content you will see the following message …

Once logged in you can access all areas of the EFSUMB web site with no additional measures.

Any member login problems please contact efsumb@efsumb.org

The EUROSON Congress 2020 takes place in Bergen from June 11.–13. 2020 We have received a total of 195 abstracts and case reports until the end of the deadline on February 29 th . This is a very high number ant it exceeds our expectations!

The review process will now start and the Scientific Committee as well as committee leaders from EFSUMB are now starting on reviewing and selecting the abstracts for oral presentation or poster presentation.

We have a limited number of slots for oral presentations, but we plan to have abstract presentations as part of several of the sessions, following invited lectures. The oral abstract presentations will be organized so they fit with the topic of the session they appear in. We also plan to exhibit posters in a central place in the congress venue, and to have selected abstracts presented in speed-poster presentations during breaks.

We truly thank all the authors for their valuable input to the Conference. Presenting new research and interesting case reports adds valuable content and makes the conference even more up-to-date on several topics.

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Interventional Ultrasound Ultrasound is a real time imaging method which makes it particularly useful for guiding interventional procedures. Over two sessions on Saturday June 13. Some of the most experienced interventional sonsographers will present useful topics. We will learn more about US guided Ablation presented by Liat Appelbaum from Israel. Torben Lorentzen from Denmark wil show how we can use US in order to place a percutaneous gastroenterostomy. Zeno Sparchez from Romania will present how he performs Contrast enhanced US guided biopsies of large retroperitoneal and renal masses. After the break Christian Nolsøe from Denmark will present how US can be part of staging of cancer and for guiding ablation of metastases. Following this Carla Serra from Italy will focus on Liver HCC/Met RFA treatment and follow-up. As complications may occur in interventional US this is important to have knowledge about, and Zeno Sparchez will focus on this topic.

Finally Boris Brkljacic from Croatia will share his experience on US guided breast ablations. This will be interesting for everyone

who are interested in interventional US or want to enter this very useful field of US.

New! Course on Interventional US with Hands-on practice on phantoms We are now planning a one day course in interventional US focusing on percutaneous tissue sampling, drainage, using Seldinger technique for placing catheteters etc. Sara Sehlstedt, Interventional Radiologist from Sweden has long experience in teaching this and will be organizing this one day course on Thursday, June 11. The course is available to all registrants, but we there will be a separate registration on the homepage when the program is ready, and the hands-on part will have limited places.

First come, first serve.

Postgraduate Course: Liver Elastography Are you curious about liver elastography or eager to improve your knowledge and practice?

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The Postgraduate Course takes place on Friday, June 12, in liver elastography is a course aimed both at those who are inexperienced and want to learn more about the method and experienced users who want to update their knowledge and improve their practical skills.

Liver elastography is established as an important clinical tool for assessment of liver fibrosis and prognosis in the diagnosis and follow-up of patients with chronic liver diseases. The field is rapidly evolving: new modalities and new indications for the use of liver elastography are emerging. The course has a limited number of 60.

Muscloskeletal US: Shoulder Shoulder pain is common, and it is difficult to find the correct causes by use only of clinical examinations. Ultrasound has been shown to give a major contribution to the diagnosis of several forms of pathologies causing pain and reduced function of the shoulder. Thus, knowledge of how to perform the optimal ultrasound examination of the shoulder is highly important for the clinicians for their diagnosis and treatment of patients with different forms of shoulder pathology.

Marnix van Holsbeeck is the director of musculoskeletal radiology in the Department of Radiology and director of radiology in the Department of Orthopaedic Surgery at the Henry Ford Health System. He is an authority in the field of musculoskeletal radiology, writing a large number of articles in the field of MSUS and is the first author for a leading radiology textbook; Musculoskeletal Ultrasound. Holsbeeck will give lectures on shoulder ultrasound including different pathologies and he will have live ultrasound demonstration on models.

We have Norwegians to teach on different shoulder pathologies; Tore Prestgaard, specialist in physical medicine (Kysthospitalet, Stavern) will talk on the important topic of capsulitis of the shoulder, Stephan Moosmaier, orthopaedic surgeon (Martina Hansens Hospital, Bærum) will teach on the topic calcifications of the shoulder and Herlof Harstad, specialist in physical medicine (Kysthospitalet, Stavern) will talk om the

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Winter moods in Bergen from Mount Fløyen. We are waiting for you!

axillary and suprascapular nerve. In addition, orthopaedic surgeon Kirsten Lundgreen (Lovisenberg Diakonale Sykehus, Oslo) will talk on the subacromial pain syndrome.

Obstetrics: Follow up of malformations As screenings and predictive medicine develop, it is important to address the psychological distress and anxiety associated with the finding of an anomaly. The detection of a fetal malformation on ultrasound also put clinicians and pregnant women in difficult and precarious situations.

What information and how it is communicated is crucial to parent’s decision-making about continuing or terminating a pregnancy. Not enough is known about how highrisk women and their partners cope while waiting for diagnostic results. Associate professor Anne Kaasen at the Faculty of Health Sciences Department of Nursing and Health Promotion at Oslo Met will present her extensive research in stress in parents after detection of a fetal anomaly.

Stina Lou, senior research scientist at DEFACTUM, Central Denmark Region and

Center for Fetal Diagnostics, Aarhus University Hospital, has a MA in anthropology and a PhD in medicine. Her research is within pregnancy and prenatal diagnosis, aspects of clinical communication, risk perception and the experiences and concerns of pregnant couples.

The session is essential for all levels in the field of obstetrics and gynecology, reproductive and fetal medicine.

Obstetrics: Ultrasound assessment of the umbilical cord A normal development of the umbilical cord is crucial for a successful outcome of pregnancy, and an abnormal cord may be an indicator for increased risk. There is an increased awareness for umbilical cord accidents as it contributes substantially to intrauterine deaths. Dr C. Ebbing is a senior consultant at the fetal medicine section, Department of obstetrics and gynecology and an assistant professor at the University of Bergen. Through epidemiology research based on data from the Medical Birth Registry of Norway and clinical research, she has focused on the cord and placenta, and associations to adverse outcome. She will give

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an overview of the theme to raise awareness, and will demonstrate how to examine the cord and placenta by ultrasound.

This session will also include presentation of submitted abstracts

Postgraduate Course: Liver Elastography Are you curious about liver elastography or eager to improve your knowledge and practice?

The Postgraduate Course in liver elastography is a course aimed both at those who are inexperienced and want to learn more about the method and experienced users who want to update their knowledge and improve their practical skills.

Liver elastography is established as an important clinical tool for assessment of liver fibrosis and prognosis in the diagnosis

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and follow-up of patients with chronic liver diseases. The field is rapidly evolving: new modalities and new indications for the use of liver elastography are emerging.

Montana Family & Youth Hostel

This postgraduate course provides an overview of the basic principles and pitfalls of the spectrum of elastography modalities given by Fabio Piscaglia, known as a brilliant lecturer and world leading expert in ultrasound and liver elastography. This is followed by presentations by leading researchers in the field regarding the use of liver elastography in various liver diseases, from viral hepatitis to alcoholic or non-alcoholic liver disease and in portal hypertension. Professor Christoph Dietrich, previous EFSUMB president, will make theory come to life in his live demonstration of liver elastography, sharing his tricks for tricky patients. Eager to try it out yourself?

There will be ample time for hands-on training with demonstration of various modalities and platforms.

It is located in beautiful surroundings up the hillside of Mount Ulriken, about 5 km south of Bergen City Centre, with good bus connections.

If you are traveling on a budget, the Montana Family & Youth Hostel is a great option.

If you buy the “Bergen Card”, you travel “free” and have free access to most of the many tourist attractions in Bergen. http://www.montana.no/en/ Please note that bed linen is not included.

Rental: NOK 50 For booking please contact bergen.monta na@hihostels.no and provide the following reference: EUROSON

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EUROSON SCHOOLS All Euroson School details can be found at www.efsumb.org

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EFSUMB CEUS Webinars – if you miss the live presentations visit the webinar archive

▪ detection of liver metastasis: Adrian Saftoiu ▪ characterisation of focal liver lesions: Alina Popescu ▪ LI-RADS classification system for HCC-suspect lesions: Fabio Piscaglia

▪ percutaneous ablation of liver lesions (RFA, MW, IRE): Franca Meloni ▪ HIFU ablations of prostate lesions: Dirk Clevert ▪ abdominal interventions: Zeno Sparchez

▪ clinical value of CEUS in ggllbladder disease: Xiang Fei ▪ CEUS diagnosis of new hepatic nodules in patients with colorectal cancer during chemotherapy: Guang-Jian Liu ▪ Combined application of navigation and contrast-enhanced ultrasound in liver tumor: Kai Li

▪ value of CEUS applications in thyroid diseases: Wen Luo ▪ Significance and value of CEUS in thyroid disease diagnosis and treatment: Hong Yang ▪ Application of contrast-enhanced ultrasound in differential diagnosis of complex gynaecology masses: Xinling Zhang

Work Related Musculoskeletal Injuries in Sonographers and Providers: The Grand Challenge Yusef Sayeed, MD, MPH, MEng1 Keziah Sully, MD2 Kristine Robinson MD3 1

2

3

Assistant Professor, Director of Pain Medicine and Functional Rehabiliation Eglin Air Force Base, Intrepid Spirit Center, Assistant Professor, Department of Physical Medicine and Rehabilitation, Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD Interventional Physiatrist, Veteran’s Administration, Department of Physical Medicine and Rehabilitation, Biloxi, MS Veteran’s Health Administration, Department of Emergency Medicine, Assistant Professor, Department of Emergency Medicine, West Virginia University, Morgantown, WV

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Correspondence: Yusef Sayeed MD 96MDG/AMDS SGPF(IWC) Eglin AFB, FL 32 542 Email: yusef.a.sayeed.civ@mail.mil Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

These views do not represent the views of the United States Air Force, the United States Veterans Health Administration or the United States Department of Defense Work related musculoskeletal disorders (WRMSD) has been widely reported among several occupations, and has taken a toll

amongst sonographers as well. WRMSD disorders among sonographers had an incidence of up to 90 %, with shoulder pain being the most prevalent complaint [1].

WRMSD are under-reported among the more experienced sonographers, as well as among those in training. Recent survey data among Emergency Medicine Ultrasound Fellows has indicated similar injury patterns among physician counterparts in the United States. In reviewing the United States Bureau of Labor Statistics database (2018 is the most recent dataset) for injury/illness of Diagnostic Medical Sonographers (29-2032) and summarizing the findings: Number of lost time injury/illness cases for Diagnostic Medical Sonographers Ultraschall in Med 2020; 41: 195–204

(29-2032) is relatively constant from 2014–2017 but with an increase in 2018.

No useful rate data. As expected, primarily upper extremity sprain/strain/pain due to overexertion due to worker positioning or motion. High level of disability (lost days) relative to other occupations [2].

Understanding the etiology of WRMSD helps address and prevent the issue. The United States Occupational Safety and Health Administration (OSHA) recognizes repetitive motions, bending, reaching overhead and working in awkward positions as known risk factors for musculoskeletal disorders, increasing the risk for a WRMSD. When these strains are not accommodated, WRMSD manifest as tendonitis, sprains, strains, bursitis, spondylosis, degenerative disc disease, and arthralgias. Continued repetition with relatively little recovery time results in chronic injury patterns. In fact, it has long been established that the primary perpetuating factor for WRMSD in the profession is poor positioning. Due to health care economics there has been a shift to increased productivity with sonographers having to provide increased exams with less rest cycles and decreased time to ergonomically accommodate the examination room [3].

There has long been a discussion both within the United States and Europe on how to best address these disorders. In fact the United States Centers for Disease Control and Prevention National Institute of Occupational Safety and Health has published guidelines to reduce WRMSD [4].

However, despite these best efforts there has not been a change in the injury patterns in the United States. The growing concern as the point of care ultrasound model continues to build these injury patterns will

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translate to our physician and provider counterparts in multiple specialties.

WRMSD has contributed to both personal and occupational impairment and disability for both individuals and employers including pain, difficulties with ADLs, lost work time (both absenteeism and presenteeism), costs incurred from lost work time (training/retraining, short term coverage employees, workers compensation insurance premium changes, and loss of productivity) and refractory cases have resulted in early retirements. Employer related costs, from both direct and indirect measures, has been estimated to be 120 billion US dollars each year. In fact, just absenteeism and lost work time alone cost employers approximately $21 153/week according to Roll et al. [5]. Recognition of this condition is vital, as it can only be prevented and addressed once it is acknowledged and prioritized. In this role, multiple national and international organizations and stakeholders have come together to form the 2020 Grand Challenge “Stop Work Related Musculoskeletal Disorders (WRMSD) Resulting from the Performance of Diagnostic Medical Ultrasound.“ [6] This Grand Challenge has been designed with a grass roots initiative among stakeholders with efforts across three main pillars: research, education, and advocacy. It has brought together leading experts in the field of sonography, manufacturing, accreditation, occupational medicine, regulatory agencies, and those stakeholders who can best advocate for change at both the national and international level. This effort will require a multifaceted approach, much like what the nursing industry was able to do with safe patient handling initiatives. This international effort will join part-

ners including the World Federation of Ultrasound in Medicine and Biology, the American Institute of Ultrasound in Medicine, the American Registry for Diagnostic Medical Sonography, the American College of Occupational and Environmental Medicine etc. … with the hopes of changing the culture, work environment, applied ergonomics, and features of hazard controls so that our friends, colleagues, and peers continue to practice what they love and continue to make a difference in our patients lives.

References [1] Murphy, Susan. Work Related Musculoskeletal Disorders in Sonography, SDMS White Paper. https://www.sdms.org/docs/default-source/ Resources/work-related-musculoskeletal-disor ders-in-sonography-white-paper.pdf?sfvrsn=8, accessed February 29th 2020 [2] United States Bureau of Labor Statistics, Injury Illnesses and Fatalities database, Survey of Occupational Injuries and Illnesses Date. https:// www.bls.gov/iif/soii-data.htm/#summary, Accessed February 29th 2020 [3] Evans K, Roll S, Baker J. Work-related musculoskeletal disorders (WRMSD) among registered diagnostic medical sonographers and vascular technologists: a representative sample. J Diagn Med Sonogr 2009; 25: 287–299 [4] Prevention of Musculoskeletal Disorders in the Workplace. Occupational Safety and Health Administration 2016. https://www.osha.gov/ SLTC/ergonomics/. Accessed July 17, 2016 [5] Roll SC et al. Contribution of Positioning to Work-Related Musculoskeletal Discomfort in Diagnostic Medical Sonographers. Work 2014; 47: 253–260 [6] Work Related Musculoskeletal Disorders Grand Challenge. https://www.ardms.org/wrmsdgrand-challenge/, American Registry for Diagnostic Medical Sonography. accessed February 29th 2020

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WFUMB 2021

EUROSON 2021

SRUMB 2021

The 18 th World Federation for Ultrasound in Medicine and Biology Congress WFUMB 2021

The 33 rd Congress of EFSUMB

MAY 26-29 2021 Timișoara, Romania

EUROSON 2021

The 24 th National Conference of The Romanian Society of Ultrasound in Medicine and Biology SRUMB 2021

wfumb2021.com

WFUMB CONGRESS 2021

PROFESIONAL CONGRESS ORGANIZER

TIMIȘOARA World Capital of Ultrasound

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