MUSCULOSKELETAL ULTRASOUND

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1 AMSSM/MAINE MEDICAL CENTER MUSCULOSKELETAL ULTRASOUND ADVANCED LEVEL COURSE CADAVER (FRESH TISSUE) INJECTION WORKSHOP CME CREDIT AVAILABLE LIMITED REGISTRATION JUNE 20-22, 2014 Portland, Maine Clarion Hotel Airport The cadaver lab will be held at the University of New England. All other educational sessions will be held at: Clarion Hotel Airport 1230 Congress Street Portland, ME 04102

2 faculty William W. Dexter, MD, FACSM Course Director, Maine Medical Center Sports Medicine, Portland, ME Erik Adams, MD, PhD Midwest Sports Medicine Institute, Middleton, WI Joseph Albano, MD Comprehensive Orthopedics Sports Medicine, Salt Lake City, UT Joanne Borg-Stein, MD Newton Wellesley Hospital, Newton, MA Kevin deweber, MD, FAAFP, FACSM PeaceHealth SW Medical Center, Vancouver, WA Douglas Hoffman, MD Essentia Health, Duluth, MN Brian Keroack, MD Rheumatology Associates, Portland, ME Sean N. Martin, DO, CAQSM Eglin AFB Family Medicine Residency, Eglin Air Force Base, FL Herb Stevenson, MD University of Massachusetts, Fitchburg, MA COURSE DESCRIPTION/TARGET AUDIENCE This two and one-half day course is designed for physicians who are already experienced in the use of ultrasound scanning and needle guidance. We wll emphasize building on sound fundamental skills and applying these skills to a wider variety of musculoskeletal pathology. Participants will learn upper and lower extremity nerve sonoanatomy and will practice nerve hydrodissection in the cadaver lab, along with injections of tendon sheaths and a wide variety of joints. COURSE HIGHLIGHTS Best aspects of course (survey comments of previous year): Hands-on time; especially in the lab Quality of teaching and lots of hands-on time Productive atmosphere that everyone created Nerve sonoanatomy and hydrodissection Tendinopathies Advanced injection techniques Scanning models with known pathologic findings Ultrasound physics Cadaver lab with fresh tissue goals and learning objectives Upon completion of this course, the participant should be able to: Improve their skills in ultrasound scanning and needle guidance. Recognize a wider variety of sonographic pathology. Locate and hydrodissect upper and lower extremity peripheral nerves. Develop an improved understanding in concepts on ultrasound physics and their effect on image quality. CME Credit AMA PRA Category 1 Credit Accreditation Statement: Maine Medical Center is accredited by the Maine Medical Association s Committee on Continuing Medical Education (CME) to physicians. Maine Medical Center designates this educational activity for a maximum of AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity. aaoa Accreditation Statement: The University of New England College of Osteopathic Medicine (UNECOM) is accredited by the American Osteopathic Association AOA) and the Maine Medical Association s Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians. The AOA Council on Continuing Medical Education approved this CME Actviity for a maximum of 15.5 hours of AOA Category 2-A CME credits. UNECOM designates this CME activity for a maximum of AMA PRA Category 1 Credits and University of New England contact hours for non-physicians. Contact hours may be submitted by non-physician, non-pa health professionals for continuing education credits. Physicians and other attendees should only claim credit commensurate with the extent of their participation in this activity. This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of University of New England College of Osteopathic Medicine (UNECOM) and AMSSM/Maine Medical Center. UNECOM is accredited by the Maine Medical Association Council on Continuing Medical Education and Accreditation to provide continuing medical education for physicians. COURSE LOCATION The cadaver lab will be held at the University of New England. All other educational sessions will be held at: Clarion Hotel 1230 Congress Street Portland, Maine (207)

3 REGISTRATION INFORMATION CONFERENCE REGISTRATION AMSSM Members $1,695.00* Non-Members $2,095.00* *PLEASE NOTE: REGISTRANTS OF PREVIOUS AMSSM/MMC MSK ULTRASOUND COURSES WILL RECEIVE A $200 DISCOUNT OFF REGISTRATION FEES ABOVE. THE DISCOUNT CODE WILL BE ED TO ALL PREVIOUS REGISTERED ATTENDEES. course registration deadline: THURSDAY, june 5, 2014 CONFERENCE REGISTRATION: Online registration is encouraged. You have the option to pay by check or credit card when registering online. A receipt will be generated upon completion of your online registration. If paying by check, please include a copy of the registration receipt you received through with your check payment when mailing your check payment to the AMSSM office. OR, print and fax/mail the registration form along with your payment to the AMSSM office. Please be aware that your spot will not be secured until your registration is processed. American Medical Society for Sports Medicine 4000 West 114th Street, Suite 100 Leawood, KS (913) (Phone) (913) (Fax) mlane@amssm.org REGISTRATION INCLUDES: Conference and meeting materials Breakfast Buffets: Saturday, June 21 and Sunday, June 22 Lunch: Saturday, June 21 REFUND POLICY NO REFUNDS WILL BE OFFERED FOR THIS COURSE. The planners and sponsors of this event claim no liability for the acts of any suppliers to this meeting, or the safety of any attendee at or while in transit to this event. The planners and sponsors reserve the right to cancel this event without penalty. Attendees who purchase non-refundable airline tickets do so at their own risk. The total amount of any liability of the planners and sponsors will be limited to a refund of the registration fee. Your submission of the registration form acknowledges acceptance of these terms. HOTEL ACCOMMODATIONS CLARION HOTEL A block of rooms has been reserved at the Clarion Hotel Airport. When making your reservation, a credit card is required to hold your room. Room Type (single/double occupancy) Room Rate/Night (plus applicable taxes) Deluxe Room $83.00 The room rate does not include the applicable taxes (currently 8.00%) in effect at the time of check-out. ROOM RESERVATION DEADLINE: JUNE 5TH OR UNTIL THE BLOCK IS FULL! The room rate can only be guaranteed until June 5, 2014 OR UNTIL THE BLOCK OF ROOMS IS SOLD OUT, WHICHEVER COMES FIRST. Please make your reservation early. HOTEL CANCELLATION POLICY Cancellation of room reservations must be completed before 6:00 p.m. on the date of arrival without penalty or first night s room plus tax will be charged. Check-in: After 3:00 p.m. Check-out: By 12:00 p.m. (noon) Hotel guest parking is complimentary. FOR RESERVATIONS To make reservations, please call (207) and request the group rate for the Maine Medical Center - Sports Medicine. AIRPORT SHUTTLE Airport Shuttle is available: for guests arriving after 10 p.m., please contact the hotel prior to arrival for reserved shuttle service. CLARION HOTEL 1230 Congress Street Portland, ME (207) (Request Reservations) IMAGE/LIKENESS/VOICE RELEASE I understand and agree that, as a result of participating in an AMSSM conference, my image, likeness or voice may be recorded by photography, video or other medicum. I hereby grant irrevocable and unrestricted permission to AMSSM and its representatives or assignees to use my image, likeness or performance in any medium and for any purpose. I hereby waive any right to inspect or approve such use of materials. Your submission of this registration form acknowledges acceptance of these terms.

4 program PLEASE NOTE: the PROGRAM IS SUBJECT TO CHANGE DUE TO UNFORSEEN MODIFICATIONS MADE TO THE EDUCATIONAL PROGRAM. 1:30 p.m. Registration CLARION hotel portland, maine friday, JUNE 20, :00 p.m. Welcome and Introductions 2:10 p.m. Lecture: Tendon Pathology 2:40 PM Lecture/Demo: Shoulder 3:00 PM Hands-on Scanning: Shoulder 4:00 PM Lecture/Demo: Hip and Pelvis 4:30 PM Hands-on Scanning: Hip and Pelvis 5:30 PM Lecture: Bump Up Your Ultrasound Diagnostics 6:00 PM Recess CADAVER LAB: UNIVERSITY OF NEW ENGLAND, BIDDEFORD, MAINE SATURDAY, JUNE 21, :00 AM Depart from the Clarion Hotel (Transportation provided to the University of New England by VIP) 7:30 AM BREAKFAST BUFFET AND ANNOUNCEMENTS (at the University of New England) (Attendees will be divided into two groups: Group 1 and Group 2) 8:00 AM Anatomy Lab I AM Anatomy Lab Injections: Hip, SI Joint, SASD Burso, AC Joint, GH Joint 9:55 AM BREAK (Change Rooms) BREAK (Change Rooms) 10:05 AM Hands-on Scanning AM Scanning Sessions: Advanced Knee Pes, Peroneal N, PCL, posterior structures and Hip/Pelvis review 12:00 PM LUNCH (during lecture) Lecture: Sonoanatomy Hands-on Scanning AM Scanning Sessions: Advanced Knee Pes, Peroneal N, PCL, posterior structures and Hip/Pelvis review Anatomy Lab I AM Anatomy Lab Injections: Hip, SI Joint, SASD Burso, AC Joint, GH Joint

5 saturday, JUNE 21, 2014 (Continued) 1:00 PM Hands-on Scanning PM Scanning Sessions: Advanced Shoulder Dynamic Studies, Suprascapular N and Abdominal Wall 2:55 PM BREAK (Change Rooms) BREAK (Change Rooms) Anatomy Lab II PM Anatomy Lab Injections: Carpal Tunnel, Nerve Blocks, Plantar Fascia, Tendon Sheath, Ankle Joint 3:05 PM Anatomy Lab II PM Anatomy Lab Injections: Carpal Tunnel, Nerve Blocks, Plantar Fascia, Tendon Sheath, Ankle Joint Hands-on Scanning PM Scanning Sessions: Advanced Shoulder Dynamic Studies, Suprascapular N and Abdominal Wall 5:00 PM Recess Depart from the University of New England to the Clarion Hotel (Transportation provided to the Clarion Hotel by VIP) 7:30 AM BREAKFAST BUFFET 8:00 AM Review/Questions 8:15 AM Lecture: Getting Certified in MSK US 8:45 AM Demo: Ankle 9:05 AM Hands-on Scanning: Ankle 10:00 AM Demo: Elbow 10:20 AM Hands-on Scanning: Elbow, etc. 11:45 AM Wrap Up 12:00 PM Adjourn clarion hotel portland, maine sunday, JUNE 22, 2014

6 AMSSM/MMC MSK US ADVANCED LEVEL COURSE CLARION HOTEL PORTLAND, ME JUNE 20-22, 2014 REGISTRATION FORM Please register online at to reserve a place at the conference. By completing online registration, you have the option to pay by check or credit card. A receipt will be generated upon completion of your online registration. If you prefer to fax or mail in your registration, please be aware that your spot will not be held until your registration has been processed. For mailed or faxed registrations, please return this form below - type or print legibly. One form must be completed for each registrant. The registration deadline is June 5, Register early! Meeting space is limited. REGISTRATION INFORMATION (Mailing address listed will be placed on the participants list) Full Name (This address will be used for the participants list) Registrant s Mailing Address Line 1 Mailing Address Line 2 City State/Province Postal Code Country (if outside USA) Office Phone Office Fax Cell Phone REGISTRATION RECEIPT WILL BE ED TO THE ADDRESSES LISTED BELOW Registrant s Address: For reimbursement purposes, please my receipt to: BADGE INFORMATION Nickname or First Name First Name Last Name Degree PHYSICAL OR DIETARY REQUIREMENTS Please check here if you have physical or dietary requirements which require accommodation in order to fully participate in this activity. Please list requirements: Company/Affiliation City State Postal Code REGISTRATION FEE ADVANCE REGISTRATION DEADLINE: JUNE 5, 2014 AMSSM Member Registration $1, AMSSM Member Discounted Registration (If attended previous AMSSM/MMC MSK Ultrasound Course) $1, Non-Member Registration $2, Non-Member Discounted Registration (If attended previous AMSSM/MMC MSK Ultrasound Course) $1, PAYMENT METHOD (Check made payable to AMSSM) Fed ID: Visa MasterCard Discover American Express Credit Card Number Expiration Date (mm/yy) Security Code (CVV) (last 3 digits on back; 4 digits on front of AMEX) Cardholder s Name Cardholder s Signature For information or to mail or fax your registration, return this form and payment to: AMSSM 4000 W. 114th Street, Ste. 100 Leawood, KS (913) (Phone) (913) (Fax) mlane@amssm.org Secured registration is available online at

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