Ottawa knee rules - Revision history

Rossdonaldson1 at 21:48, 5 March 2025

2025-03-05T21:48:00Z

← Older revision		Revision as of 21:48, 5 March 2025
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	==Background==		==Background==
			[[File:Knee diagram2.png\|thumb\|Anatomy of anterolateral aspect of right knee.]]
	*98.5% sensitive and 48.6% specific in determining knee fracture<ref>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; 140(2):121-4.</ref>		*98.5% sensitive and 48.6% specific in determining knee fracture<ref>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; 140(2):121-4.</ref>
	*Can be applied to pediatric population<ref>Bulloch B, Neto G, Plint A, et al. Validation of the Ottawa Knee Rule in children: a multicenter study. Ann Emerg Med. 2003; 42(1):48-55.</ref>		*Can be applied to pediatric population<ref>Bulloch B, Neto G, Plint A, et al. Validation of the Ottawa Knee Rule in children: a multicenter study. Ann Emerg Med. 2003; 42(1):48-55.</ref>

Rossdonaldson1 at 04:01, 9 November 2017

2017-11-09T04:01:14Z

← Older revision		Revision as of 04:01, 9 November 2017
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	==Criteria==		==Criteria==
	{{Ottawa knee rules}}		{{Ottawa knee rules}}

	~~==Radiographs==~~
	~~{{Knee x-rays}}~~

	==Caveats==		==Caveats==
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	==See Also==		==See Also==
	*[[~~Knee (Main)~~]]		*[[Acute knee injury]]
	*[[Ottawa Ankle Rules]]		*[[Ottawa Ankle Rules]]

Rossdonaldson1 at 03:56, 9 November 2017

2017-11-09T03:56:32Z

← Older revision		Revision as of 03:56, 9 November 2017
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	==Criteria==		==Criteria==
	*X-ray is only required in patients who have an acute injury '''and''' one or more of the following:		{{Ottawa knee rules}}
	**Age >55
	**Isolated tenderness of the patella
	**Tenderness at the fibular head
	**Inability flex to 90 degrees
	**Inability to walk 4 steps BOTH immediately after the injury and in the ED

	~~==Diagram==~~
	~~[[File:~~Ottawa~~-Knee.jpg]]~~

	==Radiographs==		==Radiographs==

Rossdonaldson1: Rossdonaldson1 moved page Ottawa Knee Rules to Ottawa knee rules

2017-11-09T03:55:39Z

Rossdonaldson1 moved page Ottawa Knee Rules to Ottawa knee rules

← Older revision	Revision as of 03:55, 9 November 2017
(No difference)

Rossdonaldson1: /* Radiographs */

2017-11-09T03:53:57Z

Radiographs

← Older revision		Revision as of 03:53, 9 November 2017
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	==Radiographs==		==Radiographs==
	*Three-~~vew radiograph is generally sufficient.~~		{{Knee x-rays}}
	**Anteroposterior view, lateral view, and Merchant's view (for the patellofemoral joint)
	*Teenage patients who report chronic knee pain and recurrent knee effusion → consider a notch or tunnel view (posteroanterior view with the knee flexed to 40 to 50 degrees)
	**Needed to detect radiolucencies of the femoral condyles (most commonly the medial femoral condyle), which indicate the presence of osteochondritis dissecans

	==Caveats==		==Caveats==

Mholtz at 09:16, 7 November 2017

2017-11-07T09:16:50Z

← Older revision		Revision as of 09:16, 7 November 2017
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	==Criteria==		==Criteria==
	X-ray is only required in patients who have an acute injury ~~with~~ one or more of the following:		*X-ray is only required in patients who have an acute injury '''and''' one or more of the following:
	#Age >55		**Age >55
	#Isolated tenderness of the patella ~~(no other bony tenderness).~~		**Isolated tenderness of the patella
	#Tenderness at the fibular head.		**Tenderness at the fibular head
	#Inability flex to 90 degrees		**Inability flex to 90 degrees
	#Inability to walk 4 steps BOTH immediately after the injury and in the ED		**Inability to walk 4 steps BOTH immediately after the injury and in the ED

	==Diagram==		==Diagram==
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	==Radiographs==		==Radiographs==
	~~If radiographs are required, three views are usually~~ sufficient~~: anteroposterior~~ view, lateral view, and Merchant's view (for the patellofemoral joint). Teenage patients who report chronic knee pain and recurrent knee effusion ~~require~~ a notch or tunnel view (posteroanterior view with the knee flexed to 40 to 50 degrees)~~. This view is necessary~~ to detect radiolucencies of the femoral condyles (most commonly the medial femoral condyle), which indicate the presence of osteochondritis dissecans.		*Three-vew radiograph is generally sufficient.
			**Anteroposterior view, lateral view, and Merchant's view (for the patellofemoral joint)
			*Teenage patients who report chronic knee pain and recurrent knee effusion → consider a notch or tunnel view (posteroanterior view with the knee flexed to 40 to 50 degrees)
			**Needed to detect radiolucencies of the femoral condyles (most commonly the medial femoral condyle), which indicate the presence of osteochondritis dissecans

	Radiographs should be closely inspected for signs of fracture, particularly involving the patella, tibial plateau, tibial spines, proximal fibula, and femoral condyles. If osteoarthritis is suspected, standing weight-bearing radiographs should be obtained.
	==Caveats==		==Caveats==
	*99% sensitive in children OVER age 5<ref>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; 26(4):250-3.</ref>		*99% sensitive in children OVER age 5<ref>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; 26(4):250-3.</ref>
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	==External Links==		==External Links==
	[http://www.mdcalc.com/ottawa-knee-rules/ MDCalc - Ottawa Knee Rules]		*[http://www.mdcalc.com/ottawa-knee-rules/ MDCalc - Ottawa Knee Rules]

	==See Also==		==See Also==

Ashjav at 19:36, 5 November 2017

2017-11-05T19:36:50Z

← Older revision		Revision as of 19:36, 5 November 2017
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	[[File:Ottawa-Knee.jpg]]		[[File:Ottawa-Knee.jpg]]

			==Radiographs==
			If radiographs are required, three views are usually sufficient: anteroposterior view, lateral view, and Merchant's view (for the patellofemoral joint). Teenage patients who report chronic knee pain and recurrent knee effusion require a notch or tunnel view (posteroanterior view with the knee flexed to 40 to 50 degrees). This view is necessary to detect radiolucencies of the femoral condyles (most commonly the medial femoral condyle), which indicate the presence of osteochondritis dissecans.

			Radiographs should be closely inspected for signs of fracture, particularly involving the patella, tibial plateau, tibial spines, proximal fibula, and femoral condyles. If osteoarthritis is suspected, standing weight-bearing radiographs should be obtained.
	==Caveats==		==Caveats==
	*99% sensitive in children OVER age 5<ref>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; 26(4):250-3.</ref>		*99% sensitive in children OVER age 5<ref>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; 26(4):250-3.</ref>

Ostermayer: Text replacement - "Category:Ortho" to "Category:Orthopedics"

2016-03-22T15:48:07Z

Text replacement - "Category:Ortho" to "Category:Orthopedics"

← Older revision		Revision as of 15:48, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Ortho~~]]		[[Category:Orthopedics]]

Neil.m.young: image added

2015-09-03T22:37:29Z

image added

← Older revision		Revision as of 22:37, 3 September 2015
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	#Inability flex to 90 degrees		#Inability flex to 90 degrees
	#Inability to walk 4 steps BOTH immediately after the injury and in the ED		#Inability to walk 4 steps BOTH immediately after the injury and in the ED

			==Diagram==
			[[File:Ottawa-Knee.jpg]]

	==Caveats==		==Caveats==

Neil.m.young at 22:30, 3 September 2015

2015-09-03T22:30:39Z

← Older revision		Revision as of 22:30, 3 September 2015
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	==Caveats==		==Caveats==
	#99% sensitive in children OVER age 5<ref>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; 26(4):250-3.</ref>		*99% sensitive in children OVER age 5<ref>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; 26(4):250-3.</ref>
	#Beware of the Tillaux Fracture in adolescents with anteromedial ankle pain, as they would not qualify for imaging according to this rule.		*Beware of the Tillaux Fracture in adolescents with anteromedial ankle pain, as they would not qualify for imaging according to this rule.

	==External Links==		==External Links==