Ottawa Knee Rule. 2004; 140(2):121-4. Clinical judgment should prevail if examination is ureliable: Encourage follow-up in 5-7 days if pain and ability to walk is not better. KNEE RULE. Clinical decision guidelines such as these not only avoid unnecessary health care and its costs but also help minimize exposure to ionizing radiation. The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review. A knee X-Ray series is only required for knee injury patients with any of these findings: Age 55 or older. The Ottawa Knee Rule. Für alle Bedeutungen von OKR klicken Sie bitte auf "Mehr". No bone tenderness of knee other than patella. Andere Bedeutungen von OKR Neben Ottawa-Knie-Regeln hat OKR andere Bedeutungen. MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. The Ottawa knee rule is a clinical decision aid that helps rule out fractures and avoid unnecessary radiography. 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 Purpose: The Ottawa Knee Rules were developed in order to determine the need for radiographs after acute knee injury secondary to the risk of fracture. 9. The Ottawa knee rules are a clinical decision-making strategy for determining which patients require radiographic imaging for knee pain. References. Inability to flex the knee to 90° Inability to bear weight immediately after injury and in the emergency department (4 steps) regardless of limping Rules Can't be Applied to the Following younger then 18 years old The Ottawa knee rules are a valuable tool for clinicians in the routine management of acute knee injuries. Stage of CPR Development: Validated. Bitte scrollen Sie nach unten und klicken Sie, um jeden von ihnen zu sehen. Isolated tenderness of the patella. 3) bony tenderness of fibula head. This screening tool was developed because of the need for a rapid and accurate way to avoid unnecessary imaging.Ankle sprains are a common occurrence in athletes as well as the general population. Ottawa ankle rules. Tenderness of the head of the fibula. official version of the modified score here. Describes criteria for knee trauma patients so low risk as not to warrant knee imaging. An x-ray should be performed if any of these criteria are met: Age >55 years. Sensitivity: 98-100%. OR. Rule: 1. Ottawa Knee Rules. Isolated tenderness of … X-rays are indicated when: 1) ≥ 55 years old. The Ottawa Knee Rules were derived to aid in the efficient use of radiography in acute knee injuries. The Ottawa knee rules are a set of rules used to help physicians determine whether an x-ray of the knee is needed.[1]. Calcs that help predict probability of a disease, Subcategory of 'Diagnosis' designed to be very sensitive, Disease is diagnosed: prognosticate to guide treatment. One study did find a sensitivity of just 86%. Knee pain - assessment: How do I exclude fracture using the Ottawa knee rule? Application of the Ottawa Knee Rules can cut down on the number of unnecessary radiographs by 20-30%, which has proven to be cost effective for patients without reducing quality of care. Such radiation is necessary for radiography but may raise risk for cancer, so physicians try to avoid using it whenever practical. Sie sind auf der linken Seite unten aufgeführt. “Bearing weight” counts even if the patient limps. The Ottawa Ankle Rules determine the need for radiographs in acute ankle injuries. Holroyd BR, Wilson D, Rowe BH, Mayes DC, Noseworthy T. Uptake of validated clinical practice guidelines: experience with implementing the Ottawa Ankle Rules. 2) bony tenderness of the patella ONLY. Studies show that they are highly sensitive at identifying patients with fractures of the knee and have a high degree of interobserver agreement and reproducible results. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients. Share to Twitter Share to Facebook Share to Pinterest. Check for sensitivity of the patella - only examine the patella, not the surrounding tissues 3. Ann Emerg Med. The Ottawa Knee Rules should be applied to all patients aged 2 and older with knee pain/tenderness in the setting of trauma. For Knee Injury Radiography. Application of the Ottawa knee rules in appropriate clinical scenarios may reduce the number of unnecessary radiographs ordered, … Patients without criteria for imaging by the Ottawa Knee Rules are highly unlikely to have a clinically significant fracture and do not need plain radiographs. ↑ Bulloch B, Neto G, Plint A, et al. Studies show that they are highly sensitive at identifying patients with fractures of the knee and have a high degree of interobserver agreement and reproducible results. Ottawa Ankle Rules Nach akuten Sprunggelenks- und Mittelfußdistorsionen wird bei sehr vielen Patienten eine Röntgenaufnahme gemacht, obwohl weniger als 15% eine Fraktur zeigen. The rules are outlined below. Am J Emerg Med. 2003; 42(1):48-55. Tenderness of patella is significant only if an isolated finding. Determine if the patient is able to flex his/her knee to 90° - this will be measured with a goniometer as follows:a. the axis of the goniometer is placed on the lateral epicondyle of the femurb. Graham ID, Stiell IG, Laupacis A, et al. A knee x-ray series is only required for knee injury patients with any of these findings: 1. age 55 or older OR 2. isolated tenderness of patella (no bone tenderness of knee other than patella) OR 3. tenderness of head of fibula OR 4. inability to flex to 900. The Ottawa knee rule is a clinical decision aid that helps rule out fractures and avoid unnecessary radiography. Privacy Policy. (. The Ottawa knee rules were 97 percent sensitive and 27 percent specific for knee fractures, with three fractures missed. 2001; 37(37): 259-266. OR. Specificities for the Ottawa Knee Rules typically range from 19%-50%, though the rule is not designed/intended for specific diagnosis. Check for sensitivity of the proximal fibula 2. Beschreibung in Englisch: Ottawa Knee Rules . Isolated tenderness of the patella (no other bony tenderness), Unable to bear weight both immediately and in ED (4 steps, limping is okay). In dieser Meta-Analyse wurden die Testcharakteristika der «Ottawa Knee Rules» untersucht. Stiell IG, et al. Tenderness at the head of the fibula 3. 4) unable to flex knee to 90° 5) unable to weight-bear and walk 4 steps in the ED (limping counts!) Ann Intern Med. When the Ottawa Knee Rules are executed, the following assessments will be performed: 1. 2004; … The rule has been used successfully in emergency departments for over 10 years. is intoxicated or uncooperative has other distracting painful injuries has diminished sensation in their legs has gross swelling which prevents palpation of the malleolar bone tenderness Ottawa Knee Rule: Mnemonic WAIT get an X Ray of Knee if: W Inability to bear weight (4 steps) both immediately and in ED A Age greater than or equal to 55 I Inability to Flex Knee to 90 degrees T Tenderness isolated to patella or head of fibula Posted by dr sajjad pathan at Tuesday, April 15, 2014 . Isolated patellar tenderness (A) Tenderness of the fibular head (B) Inability to flex the knee to 90° Inability to bear weight immediately after injury and in the Emergency Department. When used appropriately, the amount of knee x-rays obtained can be reduced by around 20-30%. Numerous studies found sensitivities for the Ottawa Knee Rules of 98-100% for clinically significant knee fractures. Why? However, specificity for the Ottawa knee rules is typically poor, meaning that a significant proportion of those who meet Ottawa knee criteria will have no knee fracture on X-ray. Rules have been prospectively validated on multiple occasions in different populations and in both children and adults. A meta-analysis carried out by Do… Review methods: Data were extracted on the study population, the type of Ottawa ankle rules used, and methods. Awareness and use of the Ottawa ankle and knee rules in 5 countries: can publication alone be enough to change practice? Objective: To summarise the evidence on accuracy of the Ottawa ankle rules, a decision aid for excluding fractures of the ankle and mid-foot. Daraufhin sind 1992 die Ottawa Ankle Rules entstanden. The Ottawa Knee Rules were developed in an effort to be able to minimize the number of radiographs needed for traumatic knee injuries. To summarize evidence about the accuracy of the Ottawa knee rule. 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. Themenspezifische Lehrgänge im Bereich der klinischen Orthopädie und Traumatologie, Themenkurse in verschiedenen Bereichen der medizinischen Trainingstherapie, Kurse in craniomandibulärer Dysfunktion, Sportphysiotherapie und Athletiktraining gehören ebenfalls zu unserem Angebot. The Pittsburgh knee rules have been found to be more specific in diagnosis.[3]. OTTAAW. They state that an X-ray is required only in patients who have an acute knee injury with one or more of the following: The Ottawa knee rules were derived to aid in the efficient use of radiography in acute knee injuries and have since been prospectively validated on multiple occasions in different populations and in both children and adults.
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