Article

OBJECTIVE: To determine the accuracy of knee and acromioclavicular (AC) joint
line palpation in Physical Medicine and Rehabilitation (PM&R) residents using
ultrasound (US) verification. DESIGN: Cohort study. SETTING: PM&R residency
program at an academic institution. PARTICIPANTS: Twenty-four PM&R residents
participating in a musculoskeletal US course (7 PGY-2, 8 PGY-3, and 9 PGY4
residents). METHODS: Twenty-four PM&R residents participating in an US course
were asked to palpate the AC joint and lateral joint line of the knee in a female
and male model before the start of the course. Once the presumed joint line was
localized, the residents were asked to tape an 18-gauge, 1.5-inch, blunt-tip
needle parallel to the joint line on the overlying skin. The accuracy of needle
placement over the joint line was verified using US. MAIN OUTCOME MEASURES: US
verification of correct needle placement over the joint line. RESULTS: Overall AC
joint palpation accuracy was 16.7%, and knee lateral joint line palpation
accuracy was 58.3%. Based on the resident level of education, using a value of P
< .05, there were no statistically significant differences in the accuracy of
joint line palpation. CONCLUSIONS: Residents in this study demonstrate poor
accuracy of AC joint and lateral knee joint line identification by palpation,
using US as the criterion standard for verification. There were no statistically
significant differences in the accuracy rates of joint line palpation based on
resident level of education. US may be a useful tool to use to advance the
current methods of teaching the physical examination in medical education.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS