Table 2

Final set of procedures and items to be considered for the basic, intermediate, advanced and teach-the-teachers (TTT) paediatric musculoskeletal ultrasound (PedMSUS) courses

	Item/procedure	Level of agreement (%)
Basic	Content
	Application, indications and limitations of PedMSUS in paediatric rheumatology	98
	Ultrasound physics and technology	96
	Sonographic pattern of the different musculoskeletal tissues	100
	PedMSUS artefacts and pitfalls	100
	Colour and power Doppler physics and technology	80
	Application, indications and limitations of colour and power Doppler in PedMSUS	88
	Sonoanatomy of musculoskeletal tissues in children only ≥2 years old	88
	Standard sonographic scan of the shoulder, elbow, wrist, hand, hip, knee, ankle and foot	98
	Reporting ultrasound (US) findings and diagnosis	84
	Joint synovitis	90
	Joint effusion	92
	Synovial hypertrophy	90
	Format
	Distribution between theoretical and practical part: 50%–50%	75
	Number of participants per teacher in practical sessions: 4	94
	Models used during the practical part: healthy children	87
	Residential/live courses	98
	Courses placed prior to the annual PReS congress	92
	Courses placed prior to the annual EULAR congress	82
	Courses placed prior to the joined EULAR/PReS congress	88
	Conduct
	Participants could be also (adult) rheumatologists	84
	Participants could be also radiologists	79
	Participants could be also paediatric radiologists	92
	No prerequisites (attendance to previous courses, minimum period from eventual previous courses, no of scans already performed) for attending the basic PedMSUS course	82
	The basic course should include a certification of competency	75
	The certificate of competency should be obtained in attending the full course	87
	The certificate of competency should be obtained in successful assessment of theoretical and practical skills	82
	The certificate of competency should be obtained in passing the final exam	75
Intermediate	Content
	Application, indications and limitations of PedMSUS in paediatric rheumatology	88
	PedMSUS artefacts and pitfalls	86
	Colour and power Doppler physics and technology	73*
	Application, indications and limitations of colour and power Doppler in PedMSUS	82
	Use of the colour and power Doppler settings	91
	Optimisation of colour and power Doppler settings	98
	Colour and power Doppler artefacts	98
	Use of colour and power Doppler to detect synovial and entheseal inflammation	100
	Reporting US findings and diagnosis	98
	US-guided periarticular and intra-articular injections	82
	Joint synovitis	98
	Joint effusion	93
	Synovial hypertrophy	95
	Bursitis	100
	Tenosynovitis	100
	Tendon calcification	93
	Enthesopathy	100
	Tendinosis	93
	Articular cartilage lesions	93
	Bone erosions	98
	Assessment and quantification of synovial, tenosynovial and entheseal inflammatory activity	95
	Update on PedMSUS in paediatric rheumatology	91
	Format
	Distribution between theoretical and practical part: 40%–60%	87
	Number of participants per Faculty/tutor in practical sessions: 4	91
	Models used during the practical part: patients	98
	Residential/live courses	98
	Courses placed prior to the annual PReS congress	91
	Courses placed prior to the joined EULAR/PReS congress	93
	Conduct
	Participants could be also (adult) Rheumatologists	86
	Participants could be also Radiologist	82
	Participants could be also Paediatric Radiologists	91
	The attendance to previous courses should be a prerequisite for attending the intermediate PedMSUS course	84
	The number of years of previous PedMSUS practice should be a prerequisite for attending the intermediate PedMSUS course	64*
	The number of MSUS scans performed should be a prerequisite for attending the intermediate PedMSUS course	75
	There should be a minimum period of 1 year for practising PedMSUS before the intermediate course	69*
	The intermediate course should include a certification of competency	75
	The certificate of competency should be obtained in attending the full course	84
	The certificate of competency should be obtained in successful assessment of theoretical and practical skills	89
	The certificate of competency should be obtained in passing the final exam	75
Advanced	Content
	Application, indications and limitations of colour and power Doppler in PedMSUS	75
	Optimisation of colour and power Doppler settings	75
	Use of colour and power Doppler to detect synovial and entheseal inflammation	91
	Reporting US findings and diagnosis	89
	Assessment and quantification of structural joint damage	100
	US-guided periarticular and intra-articular injections	95
	Bursitis	91
	Tenosynovitis	93
	Tendon calcification	93
	Enthesopathy	93
	Tendinosis	91
	Articular cartilage lesion	91
	Bone erosions	91
	Complete and partial tendon tear	93
	Peripheral nerve entrapment and lesions	91
	Ligament lesions	93
	Fibrocartilage lesions	95
	Myopathy	82
	Myositis	93
	Muscle injury	83
	Soft tissues masses	77
	Foreign bodies	80
	Assessment and quantification of synovial, tenosynovial and entheseal inflammatory activity	95
	Role of US in paediatric rheumatic diseases other than chronic arthritides (scleroderma, dermatomyositis, vasculitis, etc)	97
	Uncommon sonographic pathological findings in paediatric rheumatology	93
	PedMSUS technological development	95
	Three-dimensional MSUS	70*
	Update on PedMSUS in paediatric rheumatology	98
	PedMSUS research and methodology	95
	Format
	Number of participants per Faculty/tutor in practical sessions: 4	93
	Models used during the practical part: patients	100
	Residential/live courses	97
	Courses placed prior to the annual PReS congress	89
	Courses placed prior to the joined EULAR/PRES congress	93
	Conduct
	Participants could be also adult rheumatologists	84
	Participants could be also radiologists	86
	Participants could be also paediatric radiologists	95
	The attendance to previous courses should be a prerequisite for attending the advanced PedMSUS course	93
	The number of years of previous PedMSUS practice should be a prerequisite for attending the advanced PedMSUS course	70*
	The number of MSUS scans performed should be a prerequisite for attending the advanced PedMSUS course	80
	The advanced course should include a certification of competency	95
	The certificate of competency should be obtained in attending the full course	91
	The certificate of competency should be obtained in successful assessment of theoretical and practical skills	93
	The certificate of competency should be obtained in passing the final exam	88
TTT	Content
	The theoretical part of the TTT Ped-course should include teaching in how to prepare and deliver educational material in PedMSUS courses	98
	The theoretical part of the TTT Ped-course should include teaching in how to organise PedMSUS courses	93
	The lectures on how to organise a course given by the Faculty members of the TTT Ped-course should contain subjects on preparing a programme according to EULAR/PReS guidelines, financial aspects, recruiting models/patients and testing participants	93
	The practical part of the TTT Ped-course should include teaching in how to conduct a practical session in PedMSUS courses	93
	The participants should demonstrate their teaching skills by giving a representative lecture on a topic included in the EULAR/PReS basic level course and conducting a practical session on basic scanning technique during the TTT Ped-course	89
	The presentations sent and given during the TTT Ped-course by the Participants of the TTT Ped-course should include their own US images	88
	The presentations sent and given during the TTT Ped-course by the participants should include didactic anatomical images	93
	The presentation sent and given during the TTT Ped-course by the participants should show scanning technique, normal and basic pathological US findings at the assigned anatomic area or at different joint sites if applicable	95
	When demonstrating practical teaching skills the participants should interact with participants, ask open questions and actively guide them in a positive way	98
	Format
	The distribution between the practical and theoretical part in the TTT Ped-course should be 50%–50%	86
	The TTT Ped-course should be placed just prior to the EULAR Congress and linked to the EULAR/PReS sonography courses	93
	The Faculty of the TTT Ped-course should mostly include Paediatric Rheumatologists highly expert in MSUS and highly involved as Faculty members in the EULAR/PReS Sonography courses but may include other colleagues highly expert in education in MSUS	91
	Conduct
	Two types of certificate should be provided to the TTT Ped-course participants: a certificate of attendance and a certificate of successful competency assessment	75
	The certificate of successful competency assessment for the TTT Ped-course will be provided if the participants fulfil the following: (1) attendance to the full course; (2) successful assessment of theoretical and practical skills by the faculty members	98
	The competency assessment for the TTT Ped-course should be performed during the course by assessing theoretical and practical skills of the participants by the faculty members	95
	The competency assessment for the TTT Ped-course should include assessment of theoretical and practical skills of the Participants during the course by the faculty members and a final exam on teaching capabilities	89
	Before the course the TTT Ped-course faculty members provide a feedback on the presentations that the participants will deliver during the course	93

*Moderate agreement, >50 and <75%.
MSK, musculoskeletal; MSUS, musculoskeletal ultrasound; PReS, Paediatric Rheumatology European Association.