foot and ankle; ultrasonography; diagnostic imaging; musculoskeletal system; graduate medical education; physical medicine and rehabilitation medicine; physical examination
Medical Education | Musculoskeletal, Neural, and Ocular Physiology | Other Medical Specialties
Objective: The objective is to determine the accuracy of foot and ankle joint and soft tissue structure palpation in Physical Medicine and Rehabilitation (PM&R) residents using ultrasonography (US) verification.
Methods: PM&R residents were tested in an outpatient musculoskeletal (MSK) clinic on palpated foot and ankle anatomic structures in a human model. Once the presumed structures were localized, residents marked a 1 cm size circle on the overlying skin with a ink marker. The accuracy of the circle over the joint line and soft tissue structures was verified using US.
Results: The overall palpation accuracy for 22 joint line and soft tissue structures was 38.0%. Accuracy by foot and ankle region, including the posterior, medial, lateral, plantar, and dorsal were 72.9%, 47.5%, 42.5%, 35% and 7.8% respectively. There was a positive trend with level of education without a statistically significant difference in palpation accuracy (30.4% in PGY-2, 38.3% in PGY-3, 44.2% in PGY-4, p = 0.11).
Conclusions: Residents in this study demonstrated suboptimal accuracy of foot and ankle anatomic structure identification by palpation. US may be a useful adjunctive tool to advance current methods of teaching musculoskeletal examination skills to PM&R residents.
Lee, Se Won; Le, Phuong U.; Van Dien, Craig; Hansen, Mike; and Tiu, Timothy
"Evaluation of Resident Palpation Skills in Foot and Ankle Anatomic Structures Using Bedside Ultrasound,"
HCA Healthcare Journal of Medicine: Vol. 1:
3, Article 9.
Available at: https://scholarlycommons.hcahealthcare.com/hcahealthcarejournal/vol1/iss3/9