Ottawa Knee Rules: Difference between revisions
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= Purpose = | = Purpose = | ||
A clinic decision rule to help determine need for x-rays or rule out fractures of the knee after acute injury. "Plain radiographs of the knee are among the most commonly ordered radiographs in U.S. emergency departments; 60% to 80% of patients with knee pain have a knee film at an estimated annual cost of $1 billion." | A clinic decision rule to help determine need for x-rays or rule out fractures of the knee after acute injury. "Plain radiographs of the knee are among the most commonly ordered radiographs in U.S. emergency departments; 60% to 80% of patients with knee pain have a knee film at an estimated annual cost of $1 billion."<ref>1</ref> | ||
= Criteria = | = Criteria = | ||
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Pediatric Population: Sensitivity: 1.0 Specificity: .43 | Pediatric Population: Sensitivity: 1.0 Specificity: .43 | ||
+LR: 1.8 -LR: 0 | +LR: 1.8 -LR: 0 | ||
==References== | |||
Jackson JL, O'Malley PG, Kroenke, K. Evaluation of acute knee pain in primary care. Ann Intern Med. 2003 Oct 7;139(7):575-88. Review.<br> | |||
Bachmann LM, Haberzeth S, Steurer J, ter Riet, G. The accuracy of the Ottawa knee rule to rule out knee fractures:<br>a systematic review. Ann Intern Med. 2004 Jan 20;140(2):121-4. Review.<br> | |||
Revision as of 04:00, 9 December 2009
Purpose[edit | edit source]
A clinic decision rule to help determine need for x-rays or rule out fractures of the knee after acute injury. "Plain radiographs of the knee are among the most commonly ordered radiographs in U.S. emergency departments; 60% to 80% of patients with knee pain have a knee film at an estimated annual cost of $1 billion."[1]
Criteria[edit | edit source]
If one of the following is present, radiographs are indicated:
1. Age>55 years
2. Islolated patellar tenderness without other bone tenderness
3. Tenderness of the fibular head
4. Inability to flex to 90°
5. Inability to bear weight immediately after injury and in the emergency department (4 steps) regardless of limping.
Research[edit | edit source]
Diagnostic Accuracy[edit | edit source]
Adult Population: Sensitivity: 1.0 Specificity: .49-.56
+LR: 1.9-2.3 -LR: 0
A systematic review by Buchmann et al found a negative result on the Ottawa knee rule test is associated with a fracture
probability of less than 1.5% in an adult population.
Pediatric Population: Sensitivity: 1.0 Specificity: .43
+LR: 1.8 -LR: 0
References[edit | edit source]
Jackson JL, O'Malley PG, Kroenke, K. Evaluation of acute knee pain in primary care. Ann Intern Med. 2003 Oct 7;139(7):575-88. Review.
Bachmann LM, Haberzeth S, Steurer J, ter Riet, G. 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. Review.
- ↑ 1
