Post Graduate Certificate in Ultrasound Guided Injections in Musculoskeletal Medicine

If you are currently carrying out diagnostic ultrasound and want to add ultrasound guided injections to your clinical practice, then look no further!

This comprehensive course has been developed by SMUG co-faculty lead, Chris Myers and Peter Restighini, who is the course leader for the diagnostic ultrasound post-graduate certificate at the University of East London. Both Chris and Peter have extensive experience of teaching diagnostic ultrasound and ultrasound guided injections to a variety of clinicians.  The course provides a unique learning pathway accredited by the University of East London, to provide you with will all the required knowledge and skills to successfully perform ultrasound guided injections. It has been designed for those who are currently using diagnostic ultrasound and want to add ultrasound guided injections to their skill set.

Over the past few years, physiotherapists, sports doctors, GP’s, A& E consultants, orthopedic surgeons, osteopaths and podiatrists have  attended our courses . This diversity in clinical backgrounds provides a unique environment for delegates to learn from their peers and share clinical knowledge and skills.

Why did we set up the course?

1. There is a distinct lack of formal, accredited pathways for learning ultrasound guided injections. This is the only post graduate certificate in the UK to teach ultrasound guided injections.

2. Most university accredited musculoskeletal injection courses are ‘unguided injection’ courses. For clinicians who are currently using diagnostic ultrasound and want to develop their skills to include ultrasound guided injections in their clinical practice, an unguided injection course will not provide the necessary skills and knowledge.

3. Carrying out safe and effective ultrasound guided injections requires the necessary skills, supervision and knowledge. This is best achieved with a university accredited pathway with the necessary academic rigour that will provide the clinicians with a competency-based learning pathway.

4. To provide a course that covers all the necessary components for clinicians, from a variety of backgrounds, to further develop their ultrasound skills and clinical practice to carry out ultrasound guided injections. The course covers all the components of ‘unguided courses’ as well as learning all the necessary indications, pharmacological, procedural medico-legal to carry out guided injections It also teaches all the components to  perform injections using ultrasound guidance. ( is this last sentence  a  duplication of previous one?)

The Programme

The programme includes all the elements of an unguided injection course, but also teaches you how to perform injections safely and confidently  with guided ultrasound. Delegates must have basic diagnostic ultrasound skills prior to attending this course.

This post graduate certificate awards 60 M-level points and 60 CPD credits in accordance with the CPD Scheme of the Royal College of Radiologists. It consists of 2 core modules each worth 30 credits (level 7).

Module 1 (30 credits level 7)

Module 1 consists of 1 block of 4 days teaching. The first 2 days take place at the University of East London and the further 2 days at Queen Mary, University of London’s Cadaveric Laboratory. The first 2 days provide the basics of carrying out an ultrasound guided injection. We discuss the background to the value of acquiring accurate needle position in relation to key anatomical structures using ultrasound images. The content also covers pharmacology, procedural considerations, clinical governance, prescribing frameworks, medico legal considerations. The practical application will be within the context of anatomy of the upper extremity and lower extremity limb of healthy adults alongside an interpretation of common pathologies within a musculoskeletal context. The second 2 days teaching in the anatomy laboratory provides students with opportunity to practice injection techniques and scanning on cadavers and anatomical prosections. This provides an invaluable experience to the delegates to start carrying out these guided procedures in their own practice.

Programme for the 2-day cadaveric component in the anatomy laboratory as part of module 1 of the post graduate certificate in MSK guided injections.

Module 2 (30 credits level 7)

Module 2 is a practice-based learning module where the delegates must carry out 35 ultrasound guided injections under the supervision of a clinical mentorand  a 2-day teaching block.

An appropriate clinical mentor must be a:

• Radiologist with regular MSK US list
• Sonographer, Physiotherapist or Sports Physician with a PGCert / Dip
• Sonographer, Physiotherapist or Sports Physician who may not have a recognised qualification but who has regular MSK US list.

The mentor is not required to work in the same clinical environment as the student.

There is an OSCE for students to demonstrate their knowledge and skills in carrying out US guided injections. Module 2consists of a 2-day teaching block, which introduces more advanced injection techniques such as hydrodilatation, barbotage and lavage and high-volume injections. We also discuss other injectables such as PRP, hyaluronic acid and tendon fenestration.  This second module is designed to apply the skills and knowledge of the first module within an appropriately supervised clinical setting.

This has proven to be a very popular course as it is an excellent route for sports doctors, orthopaedic surgeons, A&E doctors, GP, physiotherapists and osteopaths to gain a competency in ultrasound guided injections and to add this skill to their clinical practice.

Aims of the course:

1. To develop an understanding of the principals involved in ultrasound guided injection techniques.
2. To develop appropriate motor skills to deliver a range of ultrasound guided musculoskeletal injections and develop proficiency in managing emergencies, complications, unexpected effects and aftercare.
3. To adopt an evidence-based approach to understanding the physics and instrumentation of ultrasound in the context of musculoskeletal injections.
4. To develop an enhanced knowledge of upper and lower limb human adult anatomy for specific interventional techniques.
5. Knowledge and understanding of the pharmacology of the medicines used in musculoskeletal medicine and the indications and contraindications for injection therapy.
6. To be able to communicate effectively with patients with regard to treatment options, and the integration of injection therapy into the overall management plan
7. The ability to create an accurate record of the injection therapy management delivered
8. To develop a shared decision-making approach and develop an understanding of the complexities around the consent process.

Testimonials from past students:

“I can’t recommend the Post Graduate Certificate in Musculoskeletal Ultrasound Guided Injection’s highly enough. Chris, Peter and Paul run an extremely well organised, structured course. 

The course builds from the basics, helping with hand eye coordination and needle control through to 2 days in the cadaver lab. This provides an enormous confidence boost to start to inject in practice. As well as practical components, setting up an injection service was covered including consent and different injectables. 

The course is really interactive, drawing on everyone’s experience from a whole variety of clinical practices. 

There is great accompanying reading material, including guidance on each injection which is well thumbed on my desk!”

Dr David Howells, GP and Sports Medicine Doctor

 ‘The PGCert in Ultrasound Guided Injections at the University of East London is an excellent progression for practitioners looking to extend their skill set in the musculoskeletal and sports medicine fields.

 The course is extremely practical and you are learning alongside orthopaedic specialists, physiotherapists, radiologists and sports medicine consultants which further enhances the learning experience.

 Having no injection experience before the start of the course was no problem as they recap the basics and then the more advanced procedures as the course progresses. Injection days in the cadaver lab meant all techniques can be practiced multiple times and further solidified the technical skills.

 I would recommend this course to any practitioner looking to advance their practice or any injecting clinicians looking to improve their accuracy with the addition of ultrasound guidance. Highly recommend!’

David Harris, Advanced Level Physiotherapist

At SMUG we also run a 2-day post graduate cadaveric ultrasound guided injection course at St Georges Medical School Cadaveric Laboratory at St Georges Hospital. This does not provide a competency pathway but is a very popular course for those wanting to start or refine their ultrasound guided injections.

If you have any questions about the post graduate certificate in musculoskeletal ultrasound guided injections or any of the SMUG diagnostic ultrasound courses, please do not hesitate to contact me at chris@ultrasoundtraining.co.uk

Postgraduate Certificate (PGCert) Injection Therapy Musculoskeletal Ultrasound

• University of East London – School of Health Sport and Bioscience
• Enrolment: September – 60 M-level points
• This programme provides 60 CPD credits in accordance with the CPD Scheme of the Royal College of Radiologists