Podcast: Basics of Knee Radiographs
|9632||December 2, 2013||1|
Short podcast (<15 minutes) on the Basics of Knee Radiography in the setting of trauma or acute knee pain in the Emergency Department. Topics include normal radiographic views, normal anatomy, and evaluation of the suprapatellar recess. Target audience is junior-level radiology residents and medical students and non-radiology residents on Radiology rotations. Senior radiology residents, practicing general radiologists, and non-radiologist physicians may also find the podcast informative.
Sandstrom C. Podcast: Basics of Knee Radiographs. MedEdPORTAL Publications; 2013. Available from: https://www.mededportal.org/publication/9632 http://dx.doi.org/10.15766/mep_2374-8265.9632
Contains Information Suitable for Patient Education
- After watching this enhanced podcast, the learner will have a greater understanding of normal knee radiographic views, including what to call them and how they are obtained, and of normal radiographic knee anatomy and assessment of radiographs. Once familiar with what is “normal,” the learner can then start to recognize pathology as well as identify inadequate radiographic technique, though these are not explored specifically in this podcast.
- By using the podcast, the educator can allow learners new to imaging to gain basic knowledge at their own pace and in a low-pressure setting compared with, say, a hot-seat conference.
- Learner will be able to name the 4 standard radiographic projections for adult knee trauma.
- Learner will be able to identify normal radiographic knee anatomy of the distal femur, proximal tibia, extensor mechanism, and proximal fibula.
- Learner will be able to measure the suprapatellar recess.
- Podcasts (MeSH), Radiology (MeSH), Musculoskeletal, Knee (MeSH), Radiograph, Anatomy & Histology (MeSH)
- Sports Medicine
- Orthopaedic Trauma
- Muscoskeletal Radiology
- Emergency Medicine
Knowledge for Practice
Practicing Health Professional
- Medical Student
Professional School Post-Graduate Training
Authors & Co-Authors
Claire Sandstrom, MD
University of Washington School of Medicine
Effectiveness and Significance
The podcast is small enough (19.1 MB) that it could be distributed as an attachment by our university email; alternatively, it could be posted in a central location and downloaded or played online. The residents were sent the podcast 5 days prior to attending a noon conference on Knee Trauma, with instructions to download and watch it at least once but encouraged to watch as many times as desired to feel confortable with the material. Most residents reported spending 20-30 minutes in total watching the podcast.
After attending the conference, they were asked to complete an anonymous survey, the results of which are given below.
Nine of 10 residents responded. Three were in their first month of radiology residency, while the remaining six had completed at least one year of residency. All reviewed the podcast once or twice prior to conference; most (6) reported watching it through continuously, and the rest (3) rewound multiple times to chapters of interest. Eight respondents reported the level of the material as “just right for where I am right now”; 1 entering the final year of residency reported that the podcast was, “Pretty basic but I learned at least one thing.” All of the respondents reported that the podcast improved their understanding of, and ability to engage in, the subsequent conference material. Specific comments included:
“I think podcasts are great. I have always utilized them because I can store them on my tablet and watch on the go without needing an internet connection. I really like the ones with images that are color coded and highlighted and with simple explanations.”
“Definitely. This is great because I'm not good at auditory learning, and I can go back and rewatch sections with a book in front of me until I understand. This is fantastic!”
“Excellent way to make conference time more efficient.”
“I think it's a very effective tool. For junior residents, it provides a fighting chance to get value out of the cases when they lack enough prior exposure to make sense of them. For seniors, it allows them to quickly look for gaps in their knowledge. For all, it allows periodic review when a question comes up... ‘What was that thing I learned again during [that] lecture’”
Residents were also given the opportunity to rate, as well as raise concerns or suggest changes, to different aspects of the podcast. They all reported Excellent (no issue) or Good (minor issues) with the podcast slide layout, text size, and annotations, with audio quality, sound level, and narrative speed, and with length, clarity, and accuracy of content. The same was true for Image quality except that one respondent answered “Average, could be improved” due to difficulty in seeing the soft tissue differentiation on the slides discussing fat pads.
Special Implementation Guidelines or Requirements
The podcast can be viewed in Quicktime or older versions of iTunes in just under 15 minutes from start to finish (See included document - Instructions for Viewing this Podcast). The learner is encouraged to revisit sections with which he or she is unfamiliar. The more advanced learner may also wish to skip ahead to topics of particular interest.
The chapters are as follows: Standard Projections, Anatomy, (subheadings Distal Femur, Proximal Tibia, Extensor Mechanism, Proximal Fibula), Suprapatellar Recess.
If a learner has access to knee radiographs, such as on a PACS station, on which to identify the structures in the podcast simultaneous to my description, the material may be further reinforced. However, this is not essential.
A series of 8 questions (with answer key) has been provided to test the content included in the podcast. This can be administered before and after watching the podcast or only after the podcast.
I thoroughly enjoyed the process of creating the podcast, including writing the script, creating the slides, and recording the audio. I accomplished my two key goals, which were to: 1.) Keep the time for viewing under 15 minutes to draw in learners but not overwhelm them. 2.) Keep the information basic but applicable for my target audience.
There are, of course, some issues, which of which I can address in future revisions or new podcasts, and others that are inherent to the medium. Senior residents and practicing radiologists will likely find the material presented in the podcast too basic. Since my aim was to target more junior or non-radiologist learners, additional materials will be needed to explore more advanced aspects of knee trauma radiography, including evaluation of adequate radiographic technique, common traumatic injuries, and subtle injuries that suggest more extensive soft tissue injury. While these are currently part of my teaching conference, I would like to expand them into podcasts that can be reviewed outside the classroom, such as before starting call at our busy emergency department.
Ultimately, I hope that residents and other physicians and medical students outside my own institution will be able to access and learn from my podcasts. Generalizability (particularly of the section on radiographic technique and views) may be limited, however, as not all facilities acquire the same number and types of views that we do at our emergency department and busy Level 1 trauma center. Learners from other sections or departments might wish to adopt our exam techniques, or they can just skip over that portion of the podcast if it will lead them to confusion.
The primary criticism from some of the respondents was that the image quality was limited. For example, my demonstration of fat pads was difficult to follow because they had a difficult time seeing them on the podcast video. Part of this is likely the subtlety of soft tissue differentiation on radiographs in general, and part is the inherent limitations of watching a podcast on a small screen. In the future, I will try to integrate larger and more narrowly windowed radiographs, as well as drawings/diagrams or CT/MR correlation images, to enhance more subtle findings I am trying to convey.
I hope to do many more podcasts in the future, as I feel that they are a useful way of disseminating information that residents can access at times and in ways that are convenient and helpful to them. For example, I plan to do additional “Basics of…” podcasts on other bones and joints, as well as podcasts on more advanced topics within musculoskeletal imaging and trauma and emergency radiology in general.
This information is made available under the Creative Commons license.