The Ottawa knee rules are a clinical decision-making strategy for determining which patients require radiographic imaging for knee pain.
A patient with knee pain qualifies for knee radiographs if any of the following apply:
- 55 years or older
- point tenderness at the fibular head
- isolated point tenderness of the patella
- inability to flex knee to 90°
- inability to bear weight (inability to take four steps) both immediately following the injury and in the emergency department
The Ottawa knee rules are considered to have a high sensitivity for fracture, while also reducing the overall number of radiographs obtained in an acute setting.
- the use of the Ottawa knee rules was originally validated in adults 1,2,3
- 1. Stiell IG, Greenberg GH, Wells GA et-al. Derivation of a decision rule for the use of radiography in acute knee injuries. Ann Emerg Med. 1995;26 (4): 405-13. Pubmed citation
- 2. Atkinson P, Boyle A, Chisholm E. X-ray requesting patterns before and after introduction of the Ottawa Knee Rules in a UK emergency department. Eur J Emerg Med. 2004;11 (4): 204-7. Pubmed citation
- 3. Ketelslegers E, Collard X, Vande Berg B et-al. Validation of the Ottawa knee rules in an emergency teaching centre. Eur Radiol. 2002;12 (5): 1218-20. doi:10.1007/s00330-001-1198-9 - Pubmed citation