Valentin Sebastian Schäfer

Despite a large number of studies previously conducted on educational concepts of ultrasound teaching in medical school, various controversial issues remain. Currently, recommendations for ultrasound curricula that aim to standardize ultrasound teaching are frequently based on expert panel advice instead of relying on valid evidence-based literature. In December 2022, a systematic literature review on the subject of undergraduate ultrasound education was conducted. All ultrasound studies listed in the PubMed and Google Scholar medical databases were filtered and analyzed with respect to various aspects of their methodological conduct and curricular implementation. A total of 259 publications were considered in the data synthesis, including 145 teaching studies in the field of undergraduate ultrasound education. The latter encompassed 58 (40%) studies that did not compare their ultrasound training to a control group. Furthermore, 84 (58%) of these studies did not assess knowledge prior to the applied ultrasound training, neglecting this factor’s potential influence on study outcomes. Despite a great interest in the development and further implementation of ultrasound education during medical school, this process is still compromised by significant deficiencies in studies that have been conducted in the past. In order to provide a valid basis for curricular decisions, teaching studies should fulfill essential methodological requirements despite the multifactorial framework in which they are conducted. In the future, a guide for the design of ultrasound studies could be a useful aid for ultrasound enthusiasts and promote scientific knowledge gain.

Objectives Ultrasound is a standard tool to diagnose giant cell arteritis (GCA). Until now, only a few studies have investigated the role of ultrasound in the follow-up of GCA. The aim of this study was to assess the changes in the intima–media thickness (IMT), total number of affected arteries and provisional OMERACT GCA ultrasonography score (OGUS) in a 12-months follow-up period. Methods Patients with newly diagnosed GCA were prospectively enrolled. Ultrasound examinations of facial, temporal, carotid, vertebral and axillary arteries were performed at baseline, after 3, 6, 9 and 12 months. Changes of IMT, total number of affected arteries and OGUS values were evaluated. In a subgroup of patients, exams were conducted weekly in the first 100 days. Results Fifty patients were enrolled and 36 completed the follow-up. Significant reductions in IMT, total number of affected arteries and OGUS were observed. Eighteen patients presented to weekly exams. The mean IMT of the axillary artery normalized after 7 days, while IMT of the common temporal artery normalized after 50 days. The mean OGUS values were below 1 after 6 months. There were no differences in IMT changes between GCA patients with or without PMR or between those with and without additional tocilizumab treatment. A relapse occurred in four patients. At relapse, mean IMT and OGUS were higher as compared to the preceding assessment. No predictive values indicating a relapse were identified. Conclusion Vascular ultrasound is sensitive to change in GCA. The presence of PMR or treatment with tocilizumab did not affect IMT decrease.