Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun 27;1(3):161-167.
doi: 10.36518/2689-0216.1029. eCollection 2020.

Evaluation of Resident Palpation Skills in Foot and Ankle Anatomic Structures Using Bedside Ultrasound

Se Won Lee  1 , Phuong U Le  2 , Craig Van Dien  3 , Mike Hansen  1 , Timothy Tiu  4
Affiliations

Evaluation of Resident Palpation Skills in Foot and Ankle Anatomic Structures Using Bedside Ultrasound

Se Won Lee et al. HCA Healthc J Med. .

Abstract

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.

Keywords: diagnostic imaging; foot and ankle; graduate medical education; musculoskeletal system; physical examination; physical medicine and rehabilitation medicine; ultrasonography.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest The authors declare they have no conflicts of interest.

Figures

Figure 1
Figure 1
Bedside ultrasound of the plantar heel revealed the insertion of plantar fascia on the medial calcaneal tubercle. The arrow indicates the area the resident correctly marked as the insertion site of plantar fascia (the exact location of the plantar fasciitis)
Figure 2
Figure 2
Accuracy of palpation skills based on Post-Graduate Year (PGY)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Rosas S, Krill MK, Amoo-Achampong K, Kwon K, Nwachukwu BU, McCormick F. A practical, evidence-based, comprehensive (PEC) physical examination for diagnosing pathology of the long head of the biceps. J Shoulder Elbow Surg. 2017;26(8):1484–1492. doi: 10.1016/j.jse.2017.03.002. - DOI - PMC - PubMed
    1. Young D, Papp S, Giachino A. Physical examination of the wrist. Orthop Clin North Am. 2007;38(2):149-v. doi: 10.1016/j.ocl.2007.02.011. - DOI - PubMed
    1. Mehta P, Rand EB, Visco CJ, Wyss J. Resident Accuracy of Musculoskeletal Palpation With Ultrasound Verification. J Ultrasound Med. 2018;37(7):1719–1724. doi: 10.1002/jum.14523. - DOI - PubMed
    1. Rho ME, Chu SK, Yang A, Hameed F, Lin CY, Hurh PJ. Resident accuracy of joint line palpation using ultrasound verification. PM R. 2014;6(10):920–925. doi: 10.1016/j.pmrj.2014.02.006. - DOI - PubMed
    1. Gazzillo GP, Finnoff JT, Hall MM, Sayeed YA, Smith J. Accuracy of palpating the long head of the biceps tendon: an ultrasonographic study. PM R. 2011;3(11):1035–1040. doi: 10.1016/j.pmrj.2011.02.022. - DOI - PubMed

LinkOut - more resources