To determine the accuracy of physical medicine and rehabilitation (PM&R) resident palpation of foot and ankle structures using ultrasound as verification.
30 PM&R residents palpated and marked with an assigned color marker on a male model the tibiotalar joint, talonavicular joint, calcaneocuboidal joint, 2nd and 4th tarsometatarsal joints, tibialis posterior tendon, and peroneal tendons. An attending physician then assessed each site's accuracy using a paperclip placed over each marking and scanned. The paperclip’s reverberation artifact on ultrasound determined if the marking on the surface was over the intended structure.
The primary outcome was palpation accuracy of the seven structures. The secondary outcome measures were comparisons of accuracy between class years, gender, and intended career plans.
This study demonstrates that foot and ankle anatomical knowledge and palpation skills are an area of improvement for PM&R trainees. Residency programs should strive to improve teaching of these structures.
Jason Bitterman– Resident Physician, Rutgers NJMS/Kessler Institute of Rehabilitation
Mooyeon Oh-Park– Chief Medical Officer, Professor, Burke Rehabiilitation Hospital, Albert Einstein College of Medicine
Rex Ma– Clinical Assistant Professor/Attending Physician, VA New Jersey Health Care System/Rutgers-NJMS