Pittsburgh Knee Rules: Difference between revisions

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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.&nbsp; There was the potential to reduce radiography by 52% with one missed fracture.&nbsp;<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.&nbsp; There was the potential to reduce radiography by 52% with one missed fracture.&nbsp;<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 more recent study by Cheung et al., the Pittsburgh knee rules had a pooled sensitivity of 0.86 and a pooled specificity of 0.51. <ref name="Cheung">Cheung TC, Tank Y, Breederveld RS, Tuinebreijer WE, de Lange-de Klerk ES, Derksen RJ. Diagnostic accuracy and reproducibility of the Ottawa Knee Rule vs the Pittsburgh Decision Rule. American Journal of Emergency Medicine 2013;31(4):641-5. http://www.ncbi.nlm.nih.gov/pubmed/23399332. (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 20:42, 25 April 2013

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Purpose
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A clinical decision rule used to indicate radiography of the knee.

Criteria
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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]

In a more recent study by Cheung et al., the Pittsburgh knee rules had a pooled sensitivity of 0.86 and a pooled specificity of 0.51. [3]

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. 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).
  2. 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).
  3. Cheung TC, Tank Y, Breederveld RS, Tuinebreijer WE, de Lange-de Klerk ES, Derksen RJ. Diagnostic accuracy and reproducibility of the Ottawa Knee Rule vs the Pittsburgh Decision Rule. American Journal of Emergency Medicine 2013;31(4):641-5. http://www.ncbi.nlm.nih.gov/pubmed/23399332. (Accessed 25 Apr 2013).