Objectives-Ultrasound imaging is commonly used to teach basic anatomy to medical students. The purpose of this study was to determine whether learning musculoskeletal anatomy with ultrasound improved performance on medical students' musculoskeletal physical examination skills.Methods-Twenty-seven first-year medical students were randomly assigned to 1 of 2 instructional groups: either shoulder or knee. Both groups received a lecture followed by hands-on ultrasound scanning on live human models of the assigned joint. After instruction, students were assessed on their ability to accurately palpate 4 anatomic landmarks: the acromioclavicular joint, the proximal long-head biceps tendon, and the medial and lateral joint lines of the knee. Performance scores were based on both accuracy and time. A total physical examination performance score was derived for each joint. Scores for instructional groups were compared by a 2-way analysis of variance with 1 repeated measure. Significant findings were further analyzed with post hoc tests.Results-All students performed significantly better on the knee examination, irrespective of instructional group (F 5 14.9; df 5 1.25; P 5 .001). Moreover, the shoulder instruction group performed significantly better than the knee group on the overall assessment (t 5 -3.0; df 5 25; P < .01). Post hoc analyses revealed that differences in group performance were due to the shoulder group's higher scores on palpation of the biceps tendon (t 5 -2.8; df 5 25; P 5 .01), a soft tissue landmark. Both groups performed similarly on palpation of all other anatomic structures.Conclusions-The use of ultrasound appears to provide an educational advantage when learning musculoskeletal physical examination of soft tissue landmarks.

Mixed martial arts (MMA) have enjoyed a tremendous growth in popularity over the past 10 years, yet there remains a paucity of information with respect to common injuries sustained in MMA competitions. In the available studies, certain trends pertaining to risk factors for injury, as well as the most common injuries sustained in MMA competition, were noted. Common risk factors include being the losing fighter, history of knockout or technical knockout, and longer fight duration. Common injuries that were noted include lacerations and abrasions, followed by injuries to the face and ocular region. Concussions with or without loss of consciousness also were noted in MMA competition.

Background: Outcomes for operative and nonoperative management of femoroacetabular impingement syndrome (FAIS) are variable. Understanding factors that inform patients' treatment decisions may optimize their outcomes. Objective: To identify factors that predict which patients with FAIS proceed to surgery within 90 days of their initial evaluation by an orthopedic surgeon. The study explored potential predictors of surgical intervention, including demographic factors, activity level, symptom duration, previous treatment, hip function, pain, presence of labral tear, and patient interest in surgical and physical therapy (PT) treatment. Design: Prospective cohort. Setting: Single-site academic medical center. Patients: Seventy-seven individuals with FAIS. Intervention: After evaluation in a hip preservation clinic, participants reported activity level, symptom duration, treatment history, hip function [Hip Outcome Score Activities of Daily Living(HOS-ADL)], pain severity and location, and treatment interests. These variables were evaluated based on univariate analysis for entry into a multiple binomial logistic regression to identify predictors of surgery within 90 days. Adjusted marginal prevalence ratios and 95% confidence interval estimates (PR [95% CI]) were reported (P ≤ .05). Main Outcome Measure(s): Ninety-day treatment (surgery or not). Results: Participants indicated initial interest in surgery (n = 27), PT (n = 22), both (n = 18), or neither (n = 10). Those only interested in PT had lower prevalence of diagnosed labral tear (P < .001) and previous PT for the hip (P < .001). Prevalence of previous injection was higher for those only interested in surgery than for those with any interest in PT (P < .001). Thirty-six of 77 participants (46%) underwent surgery within 90 days. Surgical interest (3.56 [1.57, 5.46]), previous hip injection (3.06 [1.73, 3.89]), younger age (0.95 [0.92, 0.98]), and worse hip function (0.97 [0.95, 0.99]) were significant (P ≤ .02) predictors of surgery. Conclusions: Treatment interest and history, patient function, and age were significantly related to participants' decision to pursue surgical intervention within 90 days. Patient engagement in the decision-making process should include considerations of patient knowledge of, and experience with, the various treatment options.

Objectives Our purpose was to determine whether ultrasound (US)‐aided instruction and practice on musculoskeletal anatomy would improve first‐year medical students’ ability to locate and identify specific soft tissue structures by unaided palpation in the upper and lower extremities of healthy human models. Methods This study was a randomized crossover design with 49 first‐year medical students randomly assigned to 1 of 2 groups. Each group was provided expert instruction and hands‐on practice using US to scan and study soft tissue structures. During session 1, group A learned the anatomy of the upper extremities, whereas group B learned the lower. Students were then tested on their proficiency in locating 4 soft tissue structures (2 upper and 2 lower extremities) through palpation of a human model. During session 2, group A learned lower extremities, and group B learned upper. At the end of session 2, students repeated the assessment. Results After the first instructional session, neither group performed significantly better on identifying and locating the soft tissue landmarks they learned aided by US. After the second instructional session, however, scores for both groups increased approximately 20 percentage points, indicating that both groups performed significantly better on palpating and identifying both the upper and lower extremity soft tissue landmarks (Cohen d = 0.89 and 0.82, respectively). Conclusions Time and practice viewing soft tissue structures with US assistance seems to have a “palpation‐with‐eyes” effect that improves students’ abilities to correctly locate, palpate, and identify limb‐specific soft tissue structures once the US assistance is removed.