Musculoskeletal Imaging and Intervention

Site(s): Vancouver General Hospital (VGH), UBC Hospital (UBCH), and BC Women’s Hospital

Overview:

Our Musculoskeletal Imaging and Intervention Fellowship is a busy program currently accepting nine fellows per year. Fellows are an integral part of the musculoskeletal services at Vancouver General Hospital and University of British Columbia Hospital, which perform a wide variety of examinations, including radiography, Ultrasound, Dual Energy CT, MRI, bone mineral density, and interventional procedures. Fellows also interpret 1.5 and 3 tesla MRI at BC Women’s Hospital and have access to some pediatric MSK radiology teaching at the adjoined BC Children’s Hospital.

Oncology and Interventional procedures:

Basic interventional procedure training for all MSK fellows includes imaging-guided soft tissue and bone biopsy, image-guided pain management, joint aspiration/injection including arthrography, and spinal injection.

For fellows with a particular interest in MSK intervention as a career path, additional training in advanced procedures including cryoablation, vertebroplasty, and cementoplastyis available. Candidates interested in advanced procedures should indicate their interest at the time of application and are expected to have already achieved an appropriate standard of basic procedural skills. For these trainees, our aim is to ensure independent advanced MSK IR practice capability by the end of the year. Due to training requirements and complexity, we can train a maximum of 3-4 fellows per year in this part of the program.

As the Vancouver General Hospital is the primary site for the management of musculoskeletal oncology, we have a strong relationship with the sarcoma program at the British Columbia Cancer Agency and participate in the program each week. Most patients are biopsied at the Vancouver General Hospital, and most staging imaging is also done at VGH. Also, a close working relationship exists with the division of palliative care at the BC Cancer Agency with a program for image-guided palliative care procedures performed at VGH.

Sports Imaging and Orthopedics:

The musculoskeletal radiology service has a close relationship with orthopedics, and fellows are encouraged to attend orthopedics grand rounds. An extensive reconstructive joint program is based at Vancouver General Hospital and UBC Hospital, providing an opportunity for evaluation of prostheses as well as aspiration and injection of joints. Vancouver General Hospital is a Level 1 Trauma Centre with a large volume of orthopedic trauma and sports injury-related imaging. The MSK division also has a close relationship with Sports Medicine at UBCH with significant volumes of sport-related injury MR imaging, DECT, and the US. MSK Fellows lead our Sport Medicine rounds at the Allen McGavin Center and are exposed to Professional Athlete imaging through our practice.

Rheumatology and Metabolic Bone Disease:

A strong relationship also exists between Musculoskeletal Radiology and Rheumatology. Our practice has a sizeable rheumatological case volume with exposure to all imaging modalities including DECT, for patients with Gout. Imaging all rheumatological disorders, including peripheral inflammatory arthritides and spondyloarthropathies, as well as MR imaging of degenerative disc disease of the spine, is standard. We interpret a large volume of spine imaging across all our sites. We also are involved in imaging metabolic bone disorders such as Gaucher’s disease. MSK Fellows are an integral part of the rheumatology rounds with the clinical team.

Research and Teaching

MSK Fellows are expected to lead a Capstone Research Project in view of publication. Fellows are encouraged to write reviews and case reports and are expected to participate in the MSK Journal Club. Some of the strongest areas of research and development at VGH and UBCH are in Sports Imaging, MSK intervention, and MSK applications of Dual Energy CT. MSK application of AI and 3D Printing is also of interest. Fellows are encouraged to present at UBC Research Day and national and international meetings such as CAR, ISS, RSNA, and ARRS. Fellows are also expected to contribute to teaching the rotating residents and medical students as well as delivering one lecture at the MSK Lecture Series in the 2nd half of their fellowship.

Clinical and Teaching Rounds

Allen McGavin Center Sports Medicine-Radiology Rounds (Fellow led)

MSK Lecture Series (Vancouver Bone Squad: Local Staff, Alumni, and International speakers)

MSTCF: Multidisciplinary Sarcoma Rounds (Fellow led)

MSTCF (R): Orthopedics Oncology-Radiology Rounds (Fellow led)

MIPPC: Palliative Rounds for Cryoablation and Cementoplasty (Fellow-led)

MSK Radiology Journal Club (Fellow led)

MSK Peer Learning Rounds including two Audits (Fellow led)

Rheumatology-Radiology Rounds (Fellow-led)

MSK Radiology Interesting Cases Rounds (Fellow led)

Vancouver Hip Institute Arthroscopy-Radiology Correlation Rounds (Fellow-led)

Radiology Grand Rounds

Orthopedics Grand Rounds

 

MSK Radiology Staff

Dr. Gordon Andrews: Vancouver Imaging Chief Operating Officer

Dr. Bruce Forster: MSK Radiologist (ISS Member)

Dr. Luck Louis: Director of MSK Ultrasound

Dr. Paul Mallinson: Director of MSK Education (ISS Member)

Dr. Peter Munk: MSK Intervention Pioneer (ISS Member)

Dr. Nicolas Murray: Director of MSK CT/DECT

Dr. Savvas Nicolaou: Vancouver Imaging Chief Executive Officer

Dr. Hugue Ouellette: Head of MSK Division (ISS Member)

Dr. Adnan Sheikh: Director of MSK MRI and Research

 

Vancouver Bone Squad (Alumni Association) 

Our graduating MSK fellows are welcome to become full members of Vancouver Bone Squad, our Alumni Association. Advantages of membership include networking with other members worldwide and access to our weekly CME accredited MSK lecture series through Zoom. Members are also invited to our social events at major meetings such as at the ISS.

 

MSK Team Recent Research Output

Papers:

  1. The Role of a Virtual Noncalcium Dual-Energy CT Application in the Detection of Bone Marrow Edema in Peripheral Osteomyelitis. Yan YY, Ouellette H, Saththianathan M, Munk PL, Mallinson PI, Sheikh A. Can Assoc Radiol J. 2022 Jan 10.
  2. Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging. Jennifer S. Weaver, Ernest R. Vina, Peter L. Munk, Andrea S. Klauser , Jamie M. Elifritz, Mihra S. Taljanovic J. Clin. Med. 2022, 11(1), 166.
  3. The diagnosis of osteoporotic vertebral fractures redux. Lentle BC, Hammond I, Leslie WD, Brown JP, Probyn L, Munk PL, Prior JC, Goltzman D. Clin Radiol. 2022 Jan;77(1):75-77. doi: 10.1016/j.crad.2021.09.021. Epub 2021 Oct 31.
  4. Localized plantar amyloidosis: case report and review of the literature. Dhatt R, Walstra F, Munk P, Ng T, Mallinson P. Skeletal Radiol. 2021 Jul;50(7):1467-1472. doi: 10.1007/s00256-020-03696-2. Epub 2021 Jan 15.
  5. A Single-Center 10-Year Retrospective Analysis of Cryoablation for the Management of Desmoid Tumors.Yan YY, Walsh JP, Munk PL, Mallinson PI, Simmons C, Clarkson PW, Jayaram PR, Heran MKS, Ouellette HA.J Vasc Interv Radiol. 2021 Sep;32(9):1277-1287. doi: 10.1016/j.jvir.2021.05.025. Epub 2021 Jun 3.PMID: 34089889.
  6. Impact of 24/7/365 Attending Radiologist Coverage on the Turnaround Time of Trauma-Related Imaging Studies Being Finalized Within 48 Hours in an Emergency Radiology Department, Offering a Perspective from a Tertiary Care Hospital. Jalal S, Ante Z, Ouellette H, Peters S, Munk P, Nicolaou S. Can Assoc Radiol J. 2021 Nov;72(4):862-870. doi: 10.1177/0846537120902046. Epub 2020 Mar 11.
  7. Does Immobilization Post Injection Reduce Contrast Extravasation in MR Arthrography of the Shoulder?. Marcuzzi A, Forster BB. Can Assoc Radiol J. Epub 2021 Jun 11:8465371211023889.
  8. The Evolving Roles of MRI and Ultrasound in First-Line Imaging of Rotator Cuff Injuries. Zoga AC, Kamel SI, Hynes JP, Kavanagh EC, O’Connor PJ, Forster BB. AJR Am J Roentgenol. 2021: 217 (6): 1390-1400
  9. Sheikh A, Forster BB.“Holding It in Your Hand”: Musculoskeletal Applications of 3D Printing.Can Assoc Radiol J. 2020 Feb 6.
  10. Kandiah JW, Chan VWY, Luo J, Dong F, Nugent JP, Forster BB. Reducing the Volume of Low-Value Outpatient MRI Joint Examinations in Patients ≥55 Years of Age. Can Assoc Radiol J. 2020 Jan 22 [Epub ahead of print)
  11. Delayed Gadolinium Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) Values are Lower in Hips with Bone Marrow Lesions. Jones CE, Cibere J, Qian H, Zhang H, Guo Y, Russell D, Forster BB, Wong H, Esdaile JM, Wilson DR. Epub 2021 Jun 16.
  12. Cryotherapy in extra-abdominal desmoid tumors: A systematic review and meta-analysis.Vora BMK, Munk PL, Somasundaram N, Ouellette HA, Mallinson PI, Sheikh A, Abdul Kadir H, Tan TJ, Yan YY. PLoS One. 2021 Dec 23;16(12):e0261657. doi: 10.1371/journal.pone.0261657. eCollection 2021.PMID: 34941915.
  13. Periarticular calcifications. Yan YY, Dous YNB, Ouellette HA, Munk PL, Murray N, Mallinson PI, Sheikh MA. Skeletal Radiol. 2021 Jun 21. doi: 10.1007/s00256-021-03842-4. PMID:34155550.
  14. Quantitative analysis of repaired rabbit supraspinatus tendons (± channeling) using magnetic resonance imaging at 7 Tesla. Trudel G, Duchesne-Bélanger S, Thomas J, Melkus G, Cron GO, Larson PEZ, Schweitzer M,Sheikh A, Louati H, Laneuville O. Quant Imaging Med Surg. 2021 Aug;11(8):3460-3471. doi: 10.21037/qims-20-1343.PMID: 34341723
  15. Preoperative bone marrow stimulation does not improve functional outcomes in arthroscopic cuff repair: a prospective randomized controlled trial. Lapner P, Pollock JW, Laneuville O, Uhthoff HK, Zhang T, Sheikh A, McIlquham K, Trudel G. Bone Joint J. 2021 Jan;103-B(1):123-130. doi: 10.1302/0301-620X.103B1.BJJ-2020-0011.R2.PMID: 33380195
  16. Improved Appropriateness of Advanced Diagnostic Imaging After Implementation of Clinical Decision Support Mechanism. Chepelev LL, Wang X, Gold B, Bonzel CL, Rybicki F Jr, Uyeda JW, Sheikh A, Anderson D, Lindaman J, Mogel G, Mitsouras D, Mahoney MC, Cai T, Rybicki FJ. J Digit Imaging. 2021 Feb 25. doi: 10.1007/s10278-021-00433-6. Online ahead of print.PMID: 33634414
  17. Repetitive trauma-induced extra-nuchal-type fibroma. Jayaram PR, Walsh J, Lari H, Mohammad N, Mallinson PI, Ouellette HA. Skeletal Radiol. 2021 Sep 23:1-5. doi: 10.1007/s00256-021-03912-7. Online ahead of print.
  18. Implications of Cone Beam CT Peripheral Edge Blurring and Signal Attenuation for Interventional Procedures. Holmes RD, Thakur Y, Mallinson P.Cardiovasc Intervent Radiol. 2022 Jan;45(1):137-141. doi: 10.1007/s00270-021-02971-6. Epub 2021 Sep 29.PMID: 34590161 No abstract available.
  19. Urate Crystals; Behond Joints. Ahmad MI, Massood S, Furlanetto, Nicolaou S.Front Med. 2021 Jun 4;8:649505
  20. Spectral Computed Tomography: Fundamental Principles and Recent Developments. So A, Nicolaou S. Korean J Radiol. 2021 Jan;22(1):86-96.
  21. Clinical Applications of Dual-Energy CT. Hamid S., Nasir MU, So A, Andrews G, Nicolaou S. Qamar SR. Korean J Radiol 2021 Jun;22(6):970-982.
  22. A Whole-Joint, unidimensional, irreversible, and fine-grained MRI knee osteoarthritis severity score, based on cartilage, osteophytes and meniscus (OA-COM). Sayre EC, Guermazi A, Nicolaou S, Esdaile JM, Kopec JA, Singer J, Wong H, Thorne A, Cibere J. PLoS One. 2021 Oct 14;16(10).

 

Books and book chapters:

  1. Interventional Radiology in Palliative Care
    Editors: Peter L. Munk and Suresh B Babu
    Springer March 2021, SBN: 978-3-030-65463-4
  2. Jayaram PB, Yan YY, Mallinson PI, Ouellette HA, Munk PL Interventional Radiologic Techniques in the Management of Bone Tumors. In Bone Cancer Bone Sarcomas and Bone Metastases – From Bench to Bedside 3rd Edition – 2021
  3. Beall DP, Munk PL, DePalma MJ, Davis T, Amirdelfan, Hunter CW. Intrathecal Pump Drug Delivery. January 2022. Springer. ISBN 978-7-030-86243-5

 

Grants:

  1. 2021 Integrating AI and IGT for Spinal Pain Managements. Cooper P, Liu D, Sheikh MA, Alexander INOVAIT grant. $125 000.
  2. 2021- 2025 The SPIN Study (The Canadian SPace hemolysIs and aNemia Study). Trudel G, Campbell M, Laneuville O, Sebastiani P, Stintzi A, Shiekh, M A. $ 200 000. Project sponsored by Canadian Space Agency.

 

 

 

Application Information:
Please see the Step by Step Application Guide to fill the application.
Incomplete applications will not be reviewed.
All documents should be in PDF format only.

 Click here to fill in the application form

FELLOWSHIP APPLICATION- STEP-BY-STEP GUIDE

Please ensure your Referees email the letters of reference directly to ubcrad.fellowship@ubc.ca before the application deadline.

Musculoskeletal Radiology Fellowship- VGH

Director/Contact Information

5 fully-funded positions 

Up to 4 Sponsored or Self-Funded positions 

 

2023-2024 Application is closed

Shortlisted candidates have been contacted.

 

Accepting applications for 2024-2025

Application Deadline 

August 31, 2022

Dr. Hugue Ouellette, Director

 

UBC Radiology
Gordon and Leslie Diamond Health Care Centre

2775 Laurel Street
Vancouver, British Columbia,

Canada V5Z 1M9

 

ubcrad.fellowship@ubc.ca