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The evaluation of podiatrists, with knowledge and training in diagnostic musculoskeletal ultrasound, to describe sonographic images of diabetic foot wounds in the United Kingdom and Australia

The evaluation of podiatrists, with knowledge and training in diagnostic musculoskeletal ultrasound, to describe sonographic images of diabetic foot wounds in the United Kingdom and Australia
The evaluation of podiatrists, with knowledge and training in diagnostic musculoskeletal ultrasound, to describe sonographic images of diabetic foot wounds in the United Kingdom and Australia

Aims: currently, wound management decisions are based largely on visual observations such as photographs, descriptors or measurements which can lack detail and do not always capture the sub-wound area. A previous case series suggests that there is benefit in using ultrasound imaging (USI) to evaluate diabetic foot ulcers (DFU) at point-of-care, however no guidance exists to inform its use. This scoping exercise explores the capacity of podiatrists with experience in interpreting musculoskeletal structures using USI to interpret sonographic images of DFU. 

Methods: following a short briefing session, podiatrists with previous musculoskeletal (MSK) USI training were asked to review and report on previously recorded static sonographic images (n = 8) of active DFU. Content analysis was utilised to identify recurring keywords within the podiatrists’ reports which were coded and assigned to categories to gain context to the data. 

Results: seven podiatrists participated in the study. Four categories were constructed for the purposes of analysis:1)Frequency of reporting, 2) Language used in reporting, 3) Observations, 4) Clinical impression Frequently, the reported findings between podiatrists were found to be similar, especially those related to bone morphology. However greater variability was seen in the reporting of wound specific soft-tissue observations. 

Conclusion: this scoping exercise has shown that podiatrists can translate their existing USI skills to make rudimentary reports on clinical findings in DFU. All participants were consistently able to identify and describe characteristics associated with DFU from a single b mode static wound ultrasound image. Findings from this investigation can be used as a foundation for further work to establish accuracy and reliability to validate DFU sonography. In conjunction the development of protocols and training materials will enable the adoption of USI to assess DFU in clinical practice. This will in turn, contribute to improved patient care and establish a new paradigm for wound surveillance which is translatable to other wound types.

Diabetes mellitus, Diabetic foot ulcer, Podiatrist, Sonography, Ultrasound
1757-1146
Dando, Charlotte
8072be3b-0c8a-4bda-8c01-5b198ea165e3
Lane, Georgia
e7de7fad-47f9-4423-aa55-f4882e79dbb6
Bowen, Catherine
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Henshaw, Frances
48319450-3704-41a5-a8b6-12cf1f56b279
Dando, Charlotte
8072be3b-0c8a-4bda-8c01-5b198ea165e3
Lane, Georgia
e7de7fad-47f9-4423-aa55-f4882e79dbb6
Bowen, Catherine
fd85c3c5-96d9-49b8-86c6-caa94e1a222b
Henshaw, Frances
48319450-3704-41a5-a8b6-12cf1f56b279

Dando, Charlotte, Lane, Georgia, Bowen, Catherine and Henshaw, Frances (2022) The evaluation of podiatrists, with knowledge and training in diagnostic musculoskeletal ultrasound, to describe sonographic images of diabetic foot wounds in the United Kingdom and Australia. Journal of Foot and Ankle Research, 15 (1), [5]. (doi:10.1186/s13047-022-00511-0).

Record type: Article

Abstract

Aims: currently, wound management decisions are based largely on visual observations such as photographs, descriptors or measurements which can lack detail and do not always capture the sub-wound area. A previous case series suggests that there is benefit in using ultrasound imaging (USI) to evaluate diabetic foot ulcers (DFU) at point-of-care, however no guidance exists to inform its use. This scoping exercise explores the capacity of podiatrists with experience in interpreting musculoskeletal structures using USI to interpret sonographic images of DFU. 

Methods: following a short briefing session, podiatrists with previous musculoskeletal (MSK) USI training were asked to review and report on previously recorded static sonographic images (n = 8) of active DFU. Content analysis was utilised to identify recurring keywords within the podiatrists’ reports which were coded and assigned to categories to gain context to the data. 

Results: seven podiatrists participated in the study. Four categories were constructed for the purposes of analysis:1)Frequency of reporting, 2) Language used in reporting, 3) Observations, 4) Clinical impression Frequently, the reported findings between podiatrists were found to be similar, especially those related to bone morphology. However greater variability was seen in the reporting of wound specific soft-tissue observations. 

Conclusion: this scoping exercise has shown that podiatrists can translate their existing USI skills to make rudimentary reports on clinical findings in DFU. All participants were consistently able to identify and describe characteristics associated with DFU from a single b mode static wound ultrasound image. Findings from this investigation can be used as a foundation for further work to establish accuracy and reliability to validate DFU sonography. In conjunction the development of protocols and training materials will enable the adoption of USI to assess DFU in clinical practice. This will in turn, contribute to improved patient care and establish a new paradigm for wound surveillance which is translatable to other wound types.

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More information

Accepted/In Press date: 11 January 2022
Published date: 25 January 2022
Additional Information: Funding Information: We would like to thank our podiatry colleagues for volunteering. Your time and expertise were greatly appreciated. Publisher Copyright: © 2022, The Author(s). Copyright: Copyright 2022 Elsevier B.V., All rights reserved.
Keywords: Diabetes mellitus, Diabetic foot ulcer, Podiatrist, Sonography, Ultrasound

Identifiers

Local EPrints ID: 455220
URI: http://eprints.soton.ac.uk/id/eprint/455220
ISSN: 1757-1146
PURE UUID: e074ccff-93a4-4319-8d75-6a6c6c5fb218
ORCID for Catherine Bowen: ORCID iD orcid.org/0000-0002-7252-9515

Catalogue record

Date deposited: 15 Mar 2022 17:41
Last modified: 23 Jul 2022 01:49

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Contributors

Author: Charlotte Dando
Author: Georgia Lane
Author: Catherine Bowen ORCID iD
Author: Frances Henshaw

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