Physical Examination and Radiographic Interpretation of Carpal Anatomy in Orthopedic Residents and Emergency Medicine Physicians

The purpose of this study was to evaluate carpal anatomy proficiency in orthopedic residents as well as emergency medicine physicians.

Orthopedic surgery residents and emergency medicine physicians were tested on their understanding of normal carpal anatomy using a Wrist Anatomy Assessment (WAA) score, which consists of both palpation of carpal bony landmarks and radiographic interpretation of the carpal bones. There were 89 participants in this study. Cohorts of orthopedic residents (n = 20), emergency medicine residents (n = 21), emergency medicine attend­ing physicians (n = 26), and 4th-year medical students (22) were used. Group size was based on 100% ortho­pedic resident involvement.

Total WAA scores (score of 17 = 100% correct) ranged from 2 to 16, with a mean of 8.6. Carpal palpation and radiographic interpretation means were both significant­ly better in the orthopedic resident cohort (total WAA score, 13.8), compared with either of the emergency medicine groups (resident total WAA score, 7.5; attend­ing total WAA score, 7.2).

Orthopedic residents have a better understanding of the clinical and radiographic anatomy of the carpal bones than emergency medicine residents and attending physi­cians. Future research to test educational interventions to improve carpal anatomy education is warranted.