Pittsburgh Knee Rules: Difference between revisions
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== Purpose<br> == | == Purpose<br> == | ||
A clinical decision rule used to indicate radiography of the knee. <br> | A clinical decision rule used to indicate radiography of the knee. <br> | ||
== Criteria<br> == | == Criteria<br> == | ||
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2) Inability to walk four weight-bearing steps | 2) Inability to walk four weight-bearing steps | ||
These rules do not apply to individuals who present more than 6 days after injury, those with only superficial lacerations and abrasions, those with a previous history of knee injury or surgery on the affected knee, and those being reassessed for the same injury. <ref>Hawley C, Rosenblatt R. Ottowa and Pittsburgh rules for acute knee injuries. The Journal of Family Practice 1998;47(4):254-255. http://ovidsp.tx.ovid.com/sp-3.8.1a/ovidweb.cgi. (Accessed 25 Apr 2013).</ref> | These rules do not apply to individuals who present more than 6 days after injury, those with only superficial lacerations and abrasions, those with a previous history of knee injury or surgery on the affected knee, and those being reassessed for the same injury. <ref>Hawley C, Rosenblatt R. Ottowa and Pittsburgh rules for acute knee injuries. The Journal of Family Practice 1998;47(4):254-255. http://ovidsp.tx.ovid.com/sp-3.8.1a/ovidweb.cgi. (Accessed 25 Apr 2013).</ref> | ||
== Evidence == | == Evidence == | ||
=== Diagnostic Accuracy === | === Diagnostic Accuracy === | ||
In a study by Seaberg et al., of 934 patients evaluated the Pittsburgh knee rules applied to 745 with a sensitivity of 0.99 and a specificity of 0.60. There was the potential to reduce radiography by 52% with one missed fracture. <ref name="Seaberg">Seaberg DC, Yealy DM, Lukens T, Auble T, Mathias S. Multicenter comparison of two clinical decision rules for the use of radiography in acute, high-risk knee injuries. Annals of Emergency Medicine 1998;32(1):8-13. http://www.ncbi.nlm.nih.gov/pubmed/9656942. (Accessed 25 Apr 2013).</ref> | In a study by Seaberg et al., of 934 patients evaluated the Pittsburgh knee rules applied to 745 with a sensitivity of 0.99 and a specificity of 0.60. There was the potential to reduce radiography by 52% with one missed fracture. <ref name="Seaberg">Seaberg DC, Yealy DM, Lukens T, Auble T, Mathias S. Multicenter comparison of two clinical decision rules for the use of radiography in acute, high-risk knee injuries. Annals of Emergency Medicine 1998;32(1):8-13. http://www.ncbi.nlm.nih.gov/pubmed/9656942. (Accessed 25 Apr 2013).</ref> | ||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == |
Revision as of 20:35, 25 April 2013
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Purpose
[edit | edit source]
A clinical decision rule used to indicate radiography of the knee.
Criteria
[edit | edit source]
Radiographs of the knee should performed if the mechanism of injury is a fall or blunt trauma and either one of the following:
1) Patient is younger than 12 or older than 50
2) Inability to walk four weight-bearing steps
These rules do not apply to individuals who present more than 6 days after injury, those with only superficial lacerations and abrasions, those with a previous history of knee injury or surgery on the affected knee, and those being reassessed for the same injury. [1]
Evidence[edit | edit source]
Diagnostic Accuracy[edit | edit source]
In a study by Seaberg et al., of 934 patients evaluated the Pittsburgh knee rules applied to 745 with a sensitivity of 0.99 and a specificity of 0.60. There was the potential to reduce radiography by 52% with one missed fracture. [2]
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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- ↑ Hawley C, Rosenblatt R. Ottowa and Pittsburgh rules for acute knee injuries. The Journal of Family Practice 1998;47(4):254-255. http://ovidsp.tx.ovid.com/sp-3.8.1a/ovidweb.cgi. (Accessed 25 Apr 2013).
- ↑ Seaberg DC, Yealy DM, Lukens T, Auble T, Mathias S. Multicenter comparison of two clinical decision rules for the use of radiography in acute, high-risk knee injuries. Annals of Emergency Medicine 1998;32(1):8-13. http://www.ncbi.nlm.nih.gov/pubmed/9656942. (Accessed 25 Apr 2013).