Rotation 3

During the second through third year of radiology residency at UW (R3-4), residents rotate through Musculoskeletal Radiology at Roosevelt, Children’s Hospital or VA. The resident is expected to run the musculoskeletal service, making sure that exams are dictated, future exams are protocoled, procedures are performed, and consultations are given.

After completing the third four-week rotation in musculoskeletal radiology, the resident will be able to:

• Demonstrate learning of knowledge based objectives and mastery of technical objectives for the third rotation
• Continue to refine skills developed during the first two rotations
• Effectively use information technology to address clinical problems
• Participate in the education of junior residents and medical students
• Become a more independent provider of musculoskeletal radiologic interpretive services
• Manage clinical and technical questions from technical and support staff

• Recognize radiologic findings and describe pathophysiology of endocrine/metabolic disease
• Recognize radiologic findings of hematopoietic and storage disease
• Demonstrate systematic approach to relatively common dysplasias and congenital conditions
• Continue learning MRI of joint pathology

• Improve and build on skills acquired during the first two rotations
• Demonstrate an understanding of indications, contraindications, needle path, risks and post procedural management of CT and US guided procedures including management of complications (MK, PC)
• Demonstrate the ability to locate, appraise and assimilate evidence from scientific studies related to the performance and interpretation of musculoskeletal imaging (PBL)
• Demonstrate the ability to teach a junior colleague how to protocol examinations and plan procedures (PC, ICS)
• Demonstrate the ability to assess and prioritize requests for add-on procedures (PC)
• Demonstrate the ability to answer common procedural and policy questions from technologists and support staff (PC, ICS)

See Abbreviations

• Report plain, and cross sectional studies from the MSK UNREAD WORKLIST
• Report STAT ER cases within a 30 minute window in preliminary format and call the ER with the results
• Successfully perform SHOULDER arthrograms under supervision by attendings or fellows: Review arthrogram videos which are available on MSK website prior to procedures. A link to our awesome online video arthrography tutorials.
• Observe all arthrograms
• Protocol CT, and MRI exams using the MSK CT & MRI protocol reference book when fellows are not available
• Observe US exams
• Complete required readings: Books are available at MSK reading room
• Attend required conferences
• Complete rotation evaluation
• Present MSK noon conference:
  1. Time : on third Wednesday at HMC
  2. Content : interesting MRI cases during the rotation

1. UW MSK website providing essential knowledge of Musculoskeletal radiology
2. Musculoskeletal MRI by Helms, Major et al.
3. MSK Imaging: A Teaching File by Chew and Roberts
4. Core Lectures in MSK Radiology (ISS and SSR)

• Morning conference at UWMC (Everyday)
• Thursday resident lecture at UWMC (Every Thursday)
• Friday Online MSK Case Conference (with UC Davis & others) at Roos & HMC (Every Friday @ Noon)
• Radiology – Rheumatology conference at ROS (Every first Friday 8:30 AM)
• Sarcoma conference at UWMC (every Tuesday @4PM) – The resident should prepare and present 2 of the cases. He/She will go to the conference in the company of the MSK fellow who is responsible for the conference. There must be one resident or fellow remaining at ROS, meaning that if there is only 1 resident on duty, that resident will go to Sarcoma Conference only if there are 2 fellows on duty (one to go, one to stay). If there are 2 residents on duty, 1 goes and 1 stays if there is only 1 fellow; if there are 2 residents and 2 fellows, both residents can go, and 1 fellow stays. The residents can go home after the conference, unless they have to clean up their work, in which case it can be done from UWMC.

At the end of each MSK rotation (core or elective), each resident will meet with MSK faculty on duty for brief exit interview during the last week. Resident will receive feedback regarding his/her performance during the month and also have opportunity to voice ideas to improve the rotation. MSK rotation evaluation should be submitted after the exit interview before the actual last date of rotation.