The ottawa knee rules calculator determines whether the patient requires knee xray for knee injury. The accuracy of the ottawa knee rule to rule out knee. The ottawa knee rule was derived to aid in the efficient use of radiography in acute knee injuries. Knee rule for knee injury radiography a knee xray series is only required for knee injury patients with any of these findings. The ottawa knee rules were derived to aid in the efficient use of radiography in acute knee injuries and. Pdf the accuracy of the ottawa knee rule to rule out knee. The ottawa knee rule describes criteria for minor knee trauma patients that are so low risk as not to warrant knee imaging.
Ottawa knee rule ottawa hospital research institute. The ottawa knee rules accurately identified fractures in. Controlled clinical trial with beforeafter and concurrent. The rule has been validated in numerous studies both in children although not recommended as sole decision rule and adults. Ottawa ankle rules ottawa hospital research institute. Do not neglect the importance of medial malleolar tenderness. Imaging is required if there is pain in the midfoot zone and any of the following. Ottawa ankle rules for the injured ankle british journal. Although validated in children, the ottawa knee rules were. Tenderness of patella is significant only if an isolated finding. This screening tool was developed because of the need for a rapid and. It consists of 5 criteria highly correlated with knee fracture status.
The ottawa knee rule is a previously validated clinical decision rule that was developed to allow physicians to be more selective and efficient in their use of plain radiography for patients with acute knee injuries. The ottawa knee rules a useful clinical decision tool racgp. The ottawa ankle rules modified buffalo rule the buffalo rule was derived to increase the diagnostic accuracy of the ottawa ankle rules, with the point tenderness criterion directed to the crest or midportion of the malleoli distal 6 cm of the fibula and tibia, reducing the likelihood of palpating over injured ligament structures. Specific physical examination maneuvers such as the lachman and mcmurray tests may be helpful when assessing for meniscal or ligamentous injury. A negative result on an ottawa knee rule test accurately excluded knee fractures after acute knee injury. The ottawa knee rule, for example, resulted in a reduction of 26. To assess the impact on clinical practice of implementing the ottawa knee rule. This screening tool was developed because of the need for a rapid and accurate way to avoid unnecessary imaging.
Ankle rules for ankle injury radiography a an ankle xray series is only required if there is any pain in malleolar zone and any of these findings. The ottawa ankle rule is useful for ruling out fracture high sensitivity, but poor for ruling in fractures many false positives. The ottawa knee rule for use of x ray in knee injury calculator assesses the use of xray in knee injury. Request pdf validation of the ottawa knee rule in children. The ottawa knee rules okrs were first derived and validated in ottawa, canada, with the aim of reducing the number of unnecessary radiographs ordered after knee trauma without compromising patient care. A clinical decision rule to determine the need for diagnostic imaging for ankle andor foot trauma. There are three sets of rules, one each for the foot, ankle and knee. The ottawa rules for ankle, knee and spine now a mobile. Implementation of the ottawa knee rule for the use of. Palpate the entire distal 6 cm of the fibula and tibia. Patients who do not meet the fracture predictor of the okrs are highly unlikely to have clinically. Plain radiographs of the knee are among the most commonly ordered radiographs in u. Commentary validity testing has shown that use of the okr in adults can reduce the need for knee x rays without jeopardising clinical outcome.
Use only for injuries 55 tenderness at head of fibula tenderness on patella inability to complete 4 steps bear weight immediately and in the ed inability to flex to 90 degrees. While all of these rules can be used in patients under the age of 18, they should be used with caution. What is the best way to evaluate an acute traumatic knee. The rules, developed by emergency department physicians at the ottawa hospital and the university of ottawa, are applied to the ankle, knee or. The ottawa knee rules accurately identified fractures in children presenting to the emergency department with a knee injury. The ottawa knee rule is a validated clinical decision rule for determining whether knee radiographs should. Racgp the ottawa knee rules a useful clinical decision.
However, because the rule is calibrated toward 100% sensitivity and actual fracture prevalences are usually low, largescale, multicentered studies are still needed to establish the costeffectiveness of routinely implementing the rule. Ottawa knee rule for use of radiographs in knee injury. Use only for injuries ottawa rules for xray of knee, ottawa ankle and foot rules lateral view ankle and foot medial view posterior edge or tip of medial malleolus navicular malleolar zone midfoot zone posterior edge or tip of lateral malleolus base of 5th metatarsal 6cm an ankle xray is required only if there is any pain in malleolar zone and any of these findings. The ottawa knee rules are a set of rules used to help physicians determine whether an xray of the knee is needed. The rate of ottawa knee rule compliance was retrospectively determined to be 63. Acute knee injuries are very common and account for a significant number of presentations in general practice and hospital emergency department settings. Pdf the ottawa knee rule is a clinical decision aid that helps rule out fractures and avoid unnecessary radiography. The ottawa knee rules are a set of rules used to help physicians determine whether an xray of. The ottawa knee rules determine the need for radiographs in acute knee injuries. The parameters used in the calculator include age, isolated tenderness of patella, inability to flex 90 degrees, inability to gear weight both immediately and in the emergency department.
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