Orthopedic Provider Accuracy for Ultrasound Detection of Peripheral Nerve Injuries: A Cadaveric Educational Study

Area of Science:

• Orthopedics
• Medical Imaging
• Ultrasound Technology

Background:

• Peripheral nerve injuries (PNIs) pose diagnostic challenges in orthopedics.
• Ultrasound (US) offers a non-invasive imaging modality for PNI assessment.
• Standardized training may enhance orthopedic providers' proficiency in US for PNIs.

Purpose of the Study:

• To evaluate the diagnostic accuracy of ultrasound in detecting peripheral nerve injuries.
• To assess the impact of a brief educational module on orthopedic providers' PNI detection skills.
• To compare the performance of handheld and cart-based ultrasound devices for PNI evaluation.

Main Methods:

• Fifteen orthopedic providers evaluated cadaveric upper-extremity nerve injury models (lacerations, neuromas, intact nerves).
• Both handheld (Butterfly iQ+) and cart-based (Sonosite SII) ultrasound devices were used.
• Assessments were conducted before and after a targeted ultrasound educational module.

Main Results:

• Diagnostic accuracy improved for nerve lacerations and intact nerves post-education.
• Accuracy in identifying neuromas remained limited.
• Performance was comparable between handheld and cart-based devices, with prior experience correlating positively with accuracy.

Conclusions:

• A focused ultrasound educational module modestly improved diagnostic accuracy for specific PNI patterns.
• Ultrasound shows potential as an adjunct tool for diagnosing nerve lacerations and intact nerves.
• Provider interpretation skills may be more critical than the specific ultrasound device used, simplifying adoption.