An electronic logbook for rheumatologists performing musculoskeletal ultrasound.

SIR, The use of musculoskeletal ultrasound by rheumatologists is an exciting and expanding area of practice. It is a common practice for trainees in other medical and surgical specialities to keep a logbook of procedures (such as gastroscopies or bronchoscopies), to be reviewed as part of the annual appraisal/record of in-training assessment (RITA) process. A logbook listing the number and type of ultrasound examinations undertaken by a trainee is a recommendation of the Royal College of Radiologists [1]. We have developed a simple electronic logbook which is designed to be completed on a handheld pocket computer (PDA) at the time of performing each scan. The logbook is based on a traditional Excel spreadsheet, with six separate pages for each commonly scanned region (hip, knee, foot and ankle, shoulder, elbow, hand and wrist). Because the logbook is an Excel spreadsheet, it can also be used on desktop or laptop personal computers (including a number of ultrasound machines). The details to record for each region were based on a recent assessment of competency in ultrasound undertaken by rheumatologists in Belfast [2]. After insertion of patient details such as date, hospital number and indication, the logbook can be completed by inserting y or n (yes or no) in each relevant box (for example: synovitis: y, erosions: n, effusion: n, Doppler signal: y). In some instances, the box can be completed by inserting numbers from 1 to 5 (for example, in the hand if there is synovitis of the 2nd and 3rd Metacarpophalangeal (MCP) joints, the numbers '2,3' are inserted into the MCP synovitis box). We have found that the details of each scan can be entered easily and quickly while scanning, particularly by those already familiar with PDAs. Only relevant boxes in each region need be completed. This logbook has two main functions: (i) by keeping a record of scans performed, it contributes useful documentation for training and appraisal purposes, particularly for specialist registrars and for rheumatologists developing ultrasound skills. (ii) because the logbook is open on a PDA at the time of scanning, it is useful as an aide memoir for the rheumatologist sonographer to decide which important features to scan and record. Rheumatologists will use ultrasound for different regions and indications, depending on their practice and experience. This logbook is easily adaptable to meet these differing needs if required. The logbook is available for download through the Rheumatology website (see supplementary …