Using ultrasound to image the foot in rheumatoid arthritis: current understanding, challenges and future scope

Bowen, Catherine; Hooper, Lindsey; Edwards, Christopher J; Arden, N K

doi:10.2217/iim.13.37

Cited by 2 publications

(3 citation statements)

References 90 publications

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“…5 Manchester Leg Circulation Service, Pennine Acute Hospitals NHS Trust, Manchester, UK. 6 Health Sciences, University of Southampton, Southampton, UK.…”

Section: Acknowledgementsmentioning

confidence: 99%

“…Musculoskeletal ultrasound has evolved into an important method for identifying musculoskeletal abnormalities, confirming the diagnosis in patients with suspected inflammatory arthritis, monitoring therapeutic response, influencing clinical decision making and guiding interventions [3][4][5][6]. The role of the non-medical health professional has advanced with many health professionals, including podiatrists undertaking training and using ultrasound imaging to extend their scope of practice [7,8] and as an outcome measure in research studies [9].…”

Section: Introductionmentioning

confidence: 99%

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Survey of ultrasound practice amongst podiatrists in the UK

Siddle

Patience

Coughtrey

et al. 2018

Journal of Foot and Ankle Research

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BackgroundUltrasound in podiatry practice encompasses musculoskeletal ultrasound imaging, vascular hand-held Doppler ultrasound and therapeutic ultrasound. Sonography practice is not regulated by the Health and Care Professions Council (HCPC), with no requirement to hold a formal qualification. The College of Podiatry does not currently define ultrasound training and competencies.This study aimed to determine the current use of ultrasound, training received and mentorship received and/or provided by podiatrists using ultrasound.MethodsA quantitative study utilising a cross-sectional, on-line, single-event survey was undertaken within the UK.ResultsCompleted surveys were received from 284 podiatrists; 173 (70%) use ultrasound as part of their general practice, 139 (49%) for musculoskeletal problems, 131 (46%) for vascular assessment and 39 (14%) to support their surgical practice. Almost a quarter (n = 62) worked for more than one organisation; 202 (71%) were employed by the NHS and/or private sector (n = 118, 41%).Nearly all (93%) respondents report using a hand-held vascular Doppler in their daily practice; 216 (82%) to support decisions regarding treatment options, 102 (39%) to provide diagnostic reports for other health professionals, and 34 (13%) to guide nerve blocks.Ultrasound imaging was used by 104 (37%) respondents primarily to aid clinical decision making (n = 81) and guide interventions (steroid injections n = 67; nerve blocks n = 39). Ninety-three percent stated they use ultrasound imaging to treat their own patients, while others scan at the request of other podiatrists (n = 28) or health professionals (n = 18). Few use ultrasound imaging for research (n = 7) or education (n = 2).Only 32 (11%) respondents (n = 20 private sector) use therapeutic ultrasound to treat patients presenting with musculoskeletal complaints, namely tendon pathologies.Few respondents (18%) had completed formal post-graduate CASE (Consortium for the Accreditation of Sonographic Education) accredited ultrasound courses.Forty (14%) respondents receive ultrasound mentorship; the majority from fellow podiatrists (n = 17) or medical colleagues (n = 15). Over half (n = 127) who do not have ultrasound mentorship indicated they would like a mentor predominantly for ultrasound imaging. Fifty-five (19%) report they currently provide ultrasound mentorship for others.ConclusionsUnderstanding the scope of ultrasound practice, the training undertaken and the requirements for mentorship will underpin the development of competencies and recommendations defined by the College of Podiatry to support professional development and ensure safe practice.Electronic supplementary materialThe online version of this article (10.1186/s13047-018-0263-4) contains supplementary material, which is available to authorized users.

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“…5 Manchester Leg Circulation Service, Pennine Acute Hospitals NHS Trust, Manchester, UK. 6 Health Sciences, University of Southampton, Southampton, UK.…”

Section: Acknowledgementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survey of ultrasound practice amongst podiatrists in the UK

Siddle

Patience

Coughtrey

et al. 2018

Journal of Foot and Ankle Research

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“…Although the use of MSUS in detecting foot pathology was suggested as a predictor of patient reported foot related future disability [24], sonographic examination of RA patients concentrated on assessing wrist and hand joints with very few studies [25,26] investigated the feet and ankles, generally on symptomatic ones.…”

Section: Discussionmentioning

confidence: 99%

Falls in Rheumatoid Patients: Does Ankle and Foot Ultrasonography have a Predictive Role? A Single-blind Study

Alkady

Abdelaziz

Abdelwahed

et al. 2021

Aktuelle Rheumatologie

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Background Rheumatoid arthritis (RA) patients have a higher prevalence of falls compared with the healthy population. Several risk factors of falls in RA have been postulated, including high disease activity, low balance, muscle weakness and non-treatment with biologics. Aim of the work We investigated our hypothesis that the sonographically detected ankle and foot changes in RA patients can predict falls in this population. To our knowledge, no previous study had investigated this before. Methods In a total of 101 RA patients, we performed assessments of disease activity, disability level, gait speed, balance status, clinical examination of ankle and foot and an MSUS assessment of the ankle and foot joints and tendons as possible risk factors of falls. Results The Berg balance test had the highest fall-predicting power (71.3%), followed by a gait speed test and restricted range of motion (ROM) of the Rt. subtalar joint, each with a predictive power of 70.3%. Of the sonographic findings, erosion of the first metatarsophalangeal (MTP) joint was the most accurate fall predictor, followed by erosion of the talonavicular joint and tenosynovitis of the ankle dorsal flexors with an area under the curve of 0.656, 0.642 and 0.614, respectively. Conclusion The use of the MSUS as an adjunct objective method for predicting falls in RA patients has not been studied before. It was found that clinical foot and balance testing was a superior and easier way of predicting falls in RA patients than using ultrasonography.

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Using ultrasound to image the foot in rheumatoid arthritis: current understanding, challenges and future scope

Cited by 2 publications

References 90 publications

Survey of ultrasound practice amongst podiatrists in the UK

Survey of ultrasound practice amongst podiatrists in the UK

Falls in Rheumatoid Patients: Does Ankle and Foot Ultrasonography have a Predictive Role? A Single-blind Study

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