Deborah Parks, M.D is the Clinical Operations Director for the Division of Rheumatology and initiated a musculoskeletal ultrasound training program for the fellowship training program in 2012.  This led to the development of an interventional and diagnostic Musculoskeletal Ultrasound Clinic where point of care musculoskeletal ultrasonography can identify subclinical synovitis as well as facilitated more precise intra-articular therapies.  This has segued into the rapid identification of early inflammatory arthritis, aiding in more targeted treatment for different types of inflammatory arthritis such as rheumatoid arthritis, psoriatic arthritis or crystalline arthritis.  It has facilitated identifying early musculoskeletal complications of immunotherapy for malignancies and need for multidisciplinary treatment plans.  Translational research projects evolving from this clinic include performance of minimally invasive ultrasound guided synovial biopsies to study pathogenesis and treatment of rheumatoid arthritis as part of the NIH Accelerating Medicines Project, biobanking of synovial fluid and peripheral blood for evaluation of musculoskeletal complications of immunotherapy for malignancies.