Chinese Taipei – Dedicated to the Pioneer Training in Ultrasound-Guided Injection for Pain Treatment

(Article Received from National Society: Taiwan Academy of Physical Medicine and Rehabilitation (TAPMR))

Authors:

1. Carl PC CHEN: Director, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
2. Simon FT TANG: Professor and Vice Dean, Department of Rehabilitation Medicine, Lotung Poh-Ai Hospital, Taiwan.
3. Der-Sheng HAN: Medical Director, National Taiwan University, Beihu Branch, Taiwan

Presently, Taiwan (Chinese Taipei) has approximately 1100 board licensed physiatrists. In order to be eligible to take the board examination, the examinee must complete 4 years of residency training in Physical and Rehabilitation medicine. During these 4 years, the examinees will receive comprehensive training in the fields of Prosthetics & Orthosis, pediatric rehabilitation, stroke rehabilitation, pain treatments, spinal cord injury, electrodiagnostic medicine, physical modalities, cancer rehabilitation, sports medicine, and urodynamic study in tertiary hospitals.

Using musculoskeletal ultrasound as a guiding tool in performing accurate injection treatment is an essential part in pain treatments. All the examinees must receive extensive training in musculoskeletal ultrasound, from diagnosis to performing guided injection treatments. Diagnostic ultrasound is one of the oral examination stations that all the examinees must be examined on. Several physiatrists have even passed the prestigious Certified Interventional Pain Sonologist (CIPS) examination held by the World Institute of Pain (WIP). During the past 2 decades, physiatrists in Taiwan has published numerous top-quality manuscripts on ultrasound-guided injection in renowned medical journals. Just to name a few, Dr Carl PC Chen and professor Simon FT Tang published the first ultrasound paper on how to perform ultrasound-guided caudal epidural injection. This paper was published in 2004 and has received over 200 citations (Figure 1). Physiatrists in Taiwan will continue to develop accurate and novel strategies in performing ultrasound-guided injections. Training and education in musculoskeletal ultrasound will only be more robust in the future.

Figure 1:

1. The ultrasound probe is placed in a longitudinal view. Patient is placed in a prone position to receive caudal epidural injection.
2. Under ultrasound guidance, the needle can be placed accurately into the sacral hiatus.