Use of ultrasound imaging to assess diabetic foot ulcer could lead to ‘new paradigm for wound surveillance’

A scoping exercise has found that podiatrists with prior knowledge and training in diagnostic musculoskeletal ultrasound are able to make rudimentary reports on clinical findings in diabetic foot ulcer.

While wound management decisions are currently based mainly on visual observations such as photographs, descriptors or measurements can lack detail and do not always capture the sub-wound area.

Dr Frances Henshaw, from the School of Medicine at Western Sydney University, teamed up with colleagues from the University of Southampton and the Podiatry Department at Solent NHS Trust, Southampton, to explore the capacity of podiatrists with experience in interpreting musculoskeletal structures using ultrasound imaging to interpret sonographic images of DFU.

Following a short briefing session, seven podiatrists who fit the criteria were asked to review and report on previously recorded static sonographic images of active DFU. The researchers then identified recurring keywords within the podiatrists’ reports, which were coded and assigned to categories to gain context to the data.

They looked at:

  • Frequency of reporting
  • Language used in reporting
  • Observations
  • Clinical impression

The reported findings between podiatrists were very often found to be similar, especially relating to bone morphology. Differences were recorded in the reporting of wound specific soft-tissue observations.

The team concluded: “This scoping exercise has shown that podiatrists can translate their existing ultrasound imaging 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 ultrasound imaging 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.”

The study has been published in the Journal of Foot and Ankle Research.

Share This Post
Have your say!