Ottawa knee rules
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.
Practical points
- the use of the Ottawa knee rules was originally validated in adults