Musculoskeletal ultrasound imaging – Integration with the biopsychosocial model

Background and Method Musculoskeletal ultrasound imaging, (MSKUSI) has become a popular imaging modality in recent years and is being utilised by a variety of professions in clinical environments beyond radiology departments. A previously published study exploring physiotherapists' interests and use of MSKUSI in practice included in-depth interviews of participants, (n=11). The data from this qualitative study were analysed thematically and five themes were identified; one was ‘Application of the biopsychosocial model’, the basis of this paper. Result The theme, ‘Application of the biopsychosocial model’ drew together three categories of analysed data: clinical reasoning, professional variance and communication opportunity. ‘Clinical reasoning’ reflected the participants' value on subjective assessment information and the integration of ultrasound imaging with physical examination findings. ‘Professional variance’ observed the scanning processes undertaken by physiotherapists tended to vary from other professionals, the physiotherapists perceived their use of dynamic imaging was greater, in particular scanning in symptom provoking positions. Another variance observed was the style of communication that physiotherapists used when scanning, this was categorised as a ‘communication opportunity’ as it represented an event that could be utilised to promote patient understanding of their presentation, link imaging findings to proposed management and enhance compliance with rehabilitation strategies. Participants emphasised their responsibility when communicating with patients to avoid language that could promote unhelpful behaviour, e.g. catastrophisation. Conclusion Participants placed value on integrating musculoskeletal ultrasound imaging into the biopsychosocial model, further research to explore the impact of this approach on patients’ clinical outcomes and reported experiences is required.