Musculoskeletal ultrasound (MSUS) has garnered significant interest within the field of rheumatology. The utilization of MSUS by rheumatologists dates back to as early as 2005. The inaugural basic ultrasound workshop took place during the 12th APLAR conference in 2006. This workshop was led by esteemed professionals such as Prof Roger Sturrock, Dr Richard Wakefield, Dr Peter Balint, Dr Kong Kok Ooi, and our own MSUS expert, Dr Anwar Samhari. In Malaysia, Dr Anwar stands as a pioneering rheumatologist in the realm of MSUS, actively participating in MSUS practices both nationally and internationally.
In Malaysia, the initial ultrasound machines were supplied by the Ministry of Health (MoH) in 2007 to three major rheumatology centers, namely Hospital Selayang, Hospital Putrajaya, and Hospital Tuanku Jaafar, Seremban. This marked a significant advancement in Musculoskeletal Ultrasound (MSUS) in rheumatology. In 2009, the fourth console ultrasound machine was placed in Hospital Tengku Ampuan Afzan. By 2012, nearly all hospitals with rheumatologists in Malaysia were equipped with ultrasound machines. This achievement was facilitated by a collaborative effort between the Ministry of Health, the Malaysian Society of Rheumatology (MSR), and partnership with Abbvie Malaysia.
Since 2008, regular workshops on Musculoskeletal Ultrasound (MSUS) have been held locally, offering basic and intermediate courses. These workshops were led by both local and international experts, providing local rheumatologists with the invaluable opportunity to enhance their ultrasound skills and expand their knowledge in the field of MSUS. Additionally, with the backing of the Ministry of Health (MoH), certain rheumatologists were afforded the opportunity to partake in overseas training programs for advanced ultrasound training.
Since March 2013, MSUS has been incorporated into the Rheumatology Sub-specialty training and accreditation.
Targeted Ultrasound Initiative (TUI) is an international effort led by a world-leading faculty of rheumatologists and ultrasound leads to help increase in the expertise of ultrasonography among a network of rheumatologists. It also aimed to create a network of researchers to undertake multi-national research to answer critical questions in the application of ultrasound to clinical practice. TUI is an educational program initiated by the TUI Group, supported by Abbott (Now Abbvie) and GE Healthcare and, additionally, by Patient Central. Abbott and GE Healthcare support the planning of the program and fund Patient Central in its role as program director to provide strategic direction and the co-ordination and delivery of its activities according to objectives set by the TUI Group and under its direction.
On the 1st August, 2012, the first TUI meeting for Asian countries was held in Hong Kong, led by Prof Paul Emery. It was attended by representatives from 6 Asian countries ie: Hong Kong, Taiwan, Japan, China, Malaysia, and Singapore. During this meeting, a TUI ambassador was elected from each country, to establish their respective national steering committees. Dr Ainon Mokhtar represented Malaysia as the first TUI ambassador. Following that, subsequent ambassadors were Dr Nor Shuhaila Shahril and Dr Ong Yew Chong.
On 24th November, 2012, Malaysian Society of Rheumatology- TUI (MSR-TUI) steering committee was formed. Led by Dr Anwar Samhari as the TUI advisor, Dr Ainon Moktar as the TUI ambassador, and four other committee members, ie: Dr Nor Shuhaila Shahril, Dr Lau Ing Soo, Dr C. Gandhi, and Dr Benjamin Cheah. With the establishment of the TUI steering committee, subsequent MSUS trainings became more structured and focused on train-the-trainers while integrating the use of ultrasound in routine rheumatology clinic practices.
MSR-TUI was established to spearhead the training of rheumatologists in Malaysia, as part of the effort to disseminate the augmented utility of ultrasound in the forefront management of rheumatoid arthritis (RA), with a focus on the treat-to-target approach. Ultrasound has progressively emerged as an indispensable tool for rheumatologists in expediting the diagnosis of various rheumatological conditions, encompassing not only RA but also a spectrum of other rheumatic diseases. Furthermore, it serves as a pivotal instrument for evaluating and monitoring disease activity and serving as a tool for ultrasound-guided joint injection. Over the past two decades, an increasing number of rheumatologists have integrated musculoskeletal ultrasound (US) as a diagnostic and disease activity monitoring tool into their clinical practice.
MSR-TUI has been actively engaged in organizing basic and intermediate musculoskeletal ultrasound training courses tailored for rheumatologists and rheumatology trainees. The aim is to equip all rheumatologists with the necessary knowledge and expertise to proficiently perform and interpret ultrasound findings. Our vision is for ultrasound to be readily available in all rheumatology centers, enabling rheumatologists to enhance patient management strategies towards a targeted treatment approach.
TUI is leading through 3 pillars ie: education, training and research.