P028 Musculoskeletal ultrasound in rheumatology vs radiology: a comparative service evaluation

Abstract Background/Aims Musculoskeletal ultrasound (MUSS) is a valuable, non-invasive tool increasingly used in rheumatology for diagnosis and monitoring. This audit compares MUSS performed by Rheumatology and Radiology departments in a single tertiary hospital, focusing on diagnostic utility and clinical impact. Methods We audited 119 patients who underwent USS: 55 by Rheumatology and 64 by Radiology. Data on demographics, scan indications, anatomical sites, inflammatory markers, treatments, and outcomes were collected. Statistical tests included t-tests, Chi-square, Fisher’s exact, and Mann-Whitney U. Results Patient demographics were similar between groups (mean age: 60.6 vs 56.2 years; p = 0.13). Rheumatology patients had higher ESR (17.1 vs 11 mm/hr; p = 0.022) but not CRP (p = 0.08). Rheumatology performed more scans per patient (1.67 vs 1.31; p = 0.006). Knee scans were significantly more common in Rheumatology (p 0.001), while wrists/hands predominated in Radiology. Rheumatology patients more often had an existing diagnosis (78.2% vs 59.4%; p = 0.046). Active inflammation was the primary scan indication in all Rheumatology cases versus 82.8% in Radiology (p = 0.004); tendinopathy was more common in Radiology (12.5% vs 0%; p = 0.007). Findings such as synovial hypertrophy, Doppler signal, effusions, and crystal deposition were more frequently reported by Rheumatology (1). Radiology more often identified enthesitis and ganglia. Post-scan, Rheumatology patients more frequently received corticosteroids (30.9% vs 12.5%; p = 0.026), further imaging (23.6% vs 7.8%; p = 0.032), and changes in immunosuppression (34.5% vs 12.5%; p = 0.008). Discharge from Rheumatology care was more common in the Radiology group (26.6% vs 3.6%; p 0.001), despite similar rates of confirmed diagnoses or new disease detection. Conclusion While both departments provided diagnostic insights, ultrasound in the Rheumatology department was associated with higher clinical impact, particularly in guiding treatment changes and identifying inflammatory disease. This supports embedding point-of-care ultrasound into routine rheumatology practice. Disclosure S. Ahmed: None. V. Syrmou: None. O. Ikram: None. S. Azam: None. A. Paul: None.