Study shows increase in musculoskeletal ultrasound utilization among podiatrists

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Between 2000 and 2009, the musculoskeletal (MSK) ultrasound volume increase among non-radiologists was much higher than that among radiologists, according to a study in the February issue of the Journal of the American College of Radiology. Ultrasound images of the MSK system provide pictures of muscles, tendons, ligaments, joints and soft tissue throughout the body.

Over the past two decades, MSK ultrasound has emerged as an effective means of diagnosing MSK pathologies. However, some insurance providers have expressed concern about increased MSK ultrasound utilization, possibly facilitated by the low cost and ready availability of ultrasound technology.

Data was obtained from the CMS Physician/Supplier Procedure Summary Master Files from 2000 to 2009, and records were extracted for procedures for extremity non-vascular ultrasound. Researchers analyzed annual volume by provider type using specialties, practice settings and geographic regions where the studies were performed.

Results showed that musculoskeletal ultrasound volume increased from 56,254 procedures in 2000 to 233,964 in 2009. However, the MSK ultrasound volume increase among non-radiologists, especially podiatrists, was far higher than that among radiologists from 2000 and 2009, with the highest growth in private offices.

"In a health care climate in which increased utilization deserves further scrutiny, this study has demonstrated significant utilization increases by specialties that are not traditional imaging providers and may be in a position to self-refer," said Richard E. Sharpe, MD, MBA, lead author of the study.

"These findings raise concern for self-referral," said Sharpe.

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