Exploring the Use of Handheld Doppler Ultrasound in Detecting Peripheral Arterial Disease: A Scoping Review

Abstract Background: The use of the handheld Doppler (HHD) is standard within podiatry and vascular guidelines, particularly during initial screenings and routine neurovascular assessments. Existing evidence correlates early detection of peripheral arterial disease (PAD) with the prevention of lower limb amputations. The aim of this scoping review (ScR) was to explore the use of the HHD for detecting PAD in podiatry and multidisciplinary team healthcare settings. Methods: The ScR was based on the Joanna Briggs Institute framework. Embase, Ovid MEDLINE, PubMed, Prospero, and reference lists of included papers between 1970 and 2025 were searched. Primary research articles were included if they reported on the use of an HHD for the assessment of pedal pulses. Research terms were developed, appropriate databases identified, and initial searches conducted. Following the removal of duplicates, gray literature, and critical appraisal, eight studies were included. Results: The main type of HHD cited in the literature was audible-only. None of the studies considered HHD assessments above the ankle region. The data on HHD assessments generated several themes: technique issues and inter- and intra-rater reliability discrepancies in public and private practice. Notably, visual waveform tracings improved reliability. Conclusion: The audible-only HHD is a simple, rapid, and inexpensive tool for detecting PAD with emerging criterion validity. There is a lack of congruency between the purpose of the HHD in detecting pedal pulses and how it is operationalized. However, the certainty of evidence is poor, and currently, systematic reviews and randomized control trials that can evidence the effectiveness of the HHD in podiatry and multidisciplinary healthcare settings are absent.