Apps that integrate touch-screens provide interactive learning for anatomy, radiology
The advent of mobile phones and apps has resulted in a transition towards learning at the bedside and “on the go.” In addition, touch-screen interfaces allow for interactive anatomic and radiographic teaching tools that are not possible with traditional education resources such as books, journals and computers. This month, we focus on three educational anatomy apps created by physicians and medical students that integrate touch-screens with interactive anatomy education: Nerve Whiz, RealWorld Orthopeadics and iJoints.
NerveWhiz, developed by a physician from the Neurology Department at the University of Michigan, is a free, comprehensive and intuitive reference tool for the brachial and lumbar plexes. The diagrams and integration of nerve roots, plexus divisions, dermatomal distributions, muscle and action set this app apart from other similar “anatomy” apps. For example, users can start with the “chart” and sort by various anatomic divisions or function. After selecting a muscle, a list is provided with all relevant information (innervating nerve, root levels, plexus trunk and cord, function and how to test function). The app also includes a detailed brachial and lumbar plexus diagram that “highlights” a selected nerve directly on the diagram. A sensory distribution selector is also available that allows the user to point to a region on the upper or lower extremity, and the app identifies the most likely nerve trunk and cord level. Lastly, the app has a “muscle localizer” function that uses data regarding muscle function to deduce the likely site of injury. For example, by entering “weak soleus” and “strong peroneus brevis,” the app suggests localization to S2 and the tibial nerve. However, changing peroneus brevis to “weak” changes the suggestion to S1 and the sciatic nerve. Overall, NerveWhiz is one of the most accurate and detailed nerve anatomy apps for the upper and lower extremity that we have seen.
RealWorld Orthopaedics was designed by medical students and physicians from Sherbrooke University in Quebec and functions as a highly detailed, radiographic reference tool for musculoskeletal conditions. The app is divided into medical headings, technical headings and chapters. Each chapter focuses on a single injury (i.e., acetabular fracture) or condition (i.e., club foot) with a brief definition, suggestions for diagnosis and important radiographic findings. A differential diagnosis is also offered, as well as treatment principles.
However, the most interesting part of the app is composed of the medical and technical sections, which include a list of more than 220 injuries and findings that are each presented as a case with radiographic images. The most impressive feature is that every radiograph (and in many cases three or four for a single injury) includes a “highlight” feature that automatically uses colored markers to identify the most salient features of a particular injury with a legend that explains the finding, significance and what is considered “normal.” For example, the unimalleolar ankle fracture case emphasizes the Weber B classification based on the level of the fibula injury, points to the tibiofibular overlap to evaluate syndesmotic injury, notes the tibiofibular and medial clear spaces, and measures the talocrural angle. Although not all of the features are immediately apparent to the user, after a few minutes of exploring it becomes clear that the cases and images contain a wealth of detailed knowledge that would enhance the education of any orthopedic or radiology trainee. At $9.99, this app is worth the price for those interested in learning more about musculoskeletal imaging.
iJoints was developed by a radiologist using the Visible Human Project to reconstruct cross-sections of the hip, knee, ankle, shoulder, elbow and wrist in cadaveric specimens. Each joint has various cross-sectional orientations (axial, coronal and sagittal) and allows the user to advance through individual slices of the joint. All images are overlaid with annotations that can be touched to identify the correct bone or muscle. In addition, all images can be flipped for either right or left orientation, and annotations can be hidden if desired. The app includes a “quiz” mode for anatomic testing based on the joint and orientation. At $0.99, this app seems most appropriate for students learning anatomy, and especially with regard to radiology-oriented slices for 3-D imaging (coronal, axial and sagittal). Thus, the app would be greatly beneficial for improving CT and MRI identification, but how this may transfer to surgical anatomy is not as clear.
We believe that the integration of augmented reality with anatomic specimens will continue to serve as a valuable teaching and reference tool for radiographic and anatomic education. These apps are just a few examples of how physicians have teamed with programmers to create informative and interactive teaching tools, and we hope that this is just a taste of more to come.
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Orrin I. Franko, MD, is a PGY4 orthopedic resident at UC San Diego. He has an interest in promoting mobile technology within orthopedic surgery and founded the website www.TopOrthoApps.com to help surgeons and trainees find the most relevant orthopedic apps for their mobile devices. He can be reached at email@example.com.
Disclosures: DiPaola and Franko have no relevant financial disclosures.