Identifying and Monitoring Deficiencies in Physical Examination of the Foot and Ankle With Diagnostic Ultrasound: Experience From a Physical Medicine and Rehabilitation Residency Training Program.

Despite the high incidence of foot and ankle injuries and their biomechanical importance to more proximal joints, the foot and ankle are some of the most daunting and underemphasized musculoskeletal structures in medical training. This study used musculoskeletal ultrasound to identify a knowledge ga...

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Publicado en:American Journal of Physical Medicine & Rehabilitation Vol. 99; no. 10; pp. 961 - 968
Autores principales: Bitterman, Jason, Oh-Park, Mooyeon, Lew, Henry L., Ma, Rex T.
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Oct2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2020
      vid: 99
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        10.1097/PHM.0000000000001425
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        atl: Identifying and Monitoring Deficiencies in Physical Examination of the Foot and Ankle With Diagnostic Ultrasound: Experience From a Physical Medicine and Rehabilitation Residency Training Program.
      aug:
        au:
          Bitterman, Jason
          Oh-Park, Mooyeon
          Lew, Henry L.
          Ma, Rex T.
        affil: From the Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey (JB)
      sug:
        subj:
          Ankle Anatomy and Histology
          Foot Anatomy and Histology
          Palpation
          Physical Examination
          Musculoskeletal System Ultrasonography
          Physical Medicine Education
          Rehabilitation Education
          Interns and Residents
          Student Knowledge Evaluation
          Human
          Cross Sectional Studies
          Educational Status
          Pearson's Correlation Coefficient
          Chi Square Test
          Male
          Female
          Ankle Injuries Ultrasonography
          Foot Injuries Ultrasonography
          Male
          Female
      ab: Despite the high incidence of foot and ankle injuries and their biomechanical importance to more proximal joints, the foot and ankle are some of the most daunting and underemphasized musculoskeletal structures in medical training. This study used musculoskeletal ultrasound to identify a knowledge gap in physical medicine and rehabilitation residents in foot and ankle surface anatomy palpation and to determine whether senior residents had higher examination performance compared with more junior residents. Physical medicine and rehabilitation residents at different levels of training were tested cross-sectionally, and palpation accuracy was compared by class year. There was a trend of improvement across class years, with significant class differences in accuracy for the talonavicular joint, calcaneocuboidal joint, and posterior tibialis and peroneal tendons (P < 0.05). Despite this trend, the accuracy was not consistently higher among the senior residents considering the training they received. For all 30 residents assessed, accuracy within 1 cm was highest for the tibiotalar joint (93.3%), peroneal tendons (83.3%), posterior tibialis tendon (63.3%), and talonavicular joint (50%). It was lower for the calcaneocuboidal joint (26.7%) and the second (13.3%) and fourth for the tarsometatarsal joints (20%). Anatomical knowledge and palpation skills of the foot and ankle, particularly at the midfoot and forefoot, may be an area of improvement for physical medicine and rehabilitation resident training.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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