Ottawa knee rule OK
In previous issues of Bandolier we have given information about the Ottawa ankle rules - a set of clinical decision rules for helping to decide when someone with an ankle injury needed an X-ray to see if there was a fracture. That the ankle rule worked was demonstrated in a number of studies. Evidently working up the body, they now give us the Ottawa knee rule to determine whether a knee injury needs an X-ray. The knee rule is given in below.
A knee X-ray series is only required for knee injury patients with any of these findings:
Eligible patients were those seen in the twelve months before and after the introduction on the rule. Clearly not all patients would be eligible and, for example, patients younger than 18 or those with major trauma were not regarded as suitable candidates for use of the decision rule.
|The knee rule correctly predicted all the fractures. No patient
who did not have an X-ray was found subsequently to have a fracture.
Time spent in the emergency department, time spent off work, and overall medical costs were lower (by US$103 per patient) in those who did not have an X-ray than those who did.
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