Ottawa knee rules
Criteria:
X-ray is only required in patients who have an acute injury with one or more of the following:
- Age >55
- Isolated tenderness of the patella (no other bony tenderness).
- Tenderness at the fibular head.
- Inability flex to 90 degrees
- Inability to walk 4 steps BOTH immediately after the injury and in the ED
References
- Bachmann LM, Haberzeth S, Steurer J, et al. The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review. Ann Intern Med. 2004 Jan 20;140(2):121-4.
- Bulloch B, Neto G, Plint A, et al. Validation of the Ottawa Knee Rule in children: a multicenter study. Ann Emerg Med. 2003 Jul;42(1):48-55.
- Stiell IG, Greenberg GH, Wells GA, et al. Derivation of a decision rule for the use of radiography in acute knee injuries. Ann Emerg Med. 1995 Oct;26(4):405-13.
- Stiell IG, Greenberg GH, Wells GA, et al. Prospective validation of a decision rule for the use of radiography in acute knee injuries. JAMA. 1996 Feb 28;275(8):611-5.
- Stiell IG, Wells GA, Hoag RH, et al. Implementation of the Ottawa Knee Rule for the use of radiography in acute knee injuries. JAMA. 1997 Dec 17;278(23):2075-9.
- Vijayasankar D, Boyle AA, Atkinson P. Can the Ottawa knee rule be applied to children? A systematic review and meta-analysis of observational studies. Emerg Med J. 2009 Apr;26(4):250-3.