In this study, both the Ottawa and Pittsburgh rules showed high sensitivity in detecting knee fractures [5]. Other clinical decision criteria were tested. In an emergency department, in a study of 242 patients >17 years with isolated knee injuries sustained 24 hours previously, Weber et al [3] were able to exclude clinically significant fractures in patients >18 years who could walk without limping or if there was a twisting injury to the knee and no joint effusion. These clinical decision rules were effective in detecting knee fractures with 100% sensitivity and with sufficient specificity to eliminate 29% of knee radiographs [3]. Bone Scan with SPECT or SPECT/CT Knee Tc-99m bone scan with single-photon emission computed tomography (SPECT)/CT knee is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. US Knee US is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. Variant 2: Adult or child 5 years of age or older. Fall or acute twisting trauma to the knee. One or more of the following: focal tenderness, effusion, inability to bear weight. Initial imaging. CT Knee CT is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. MR Arthrography Knee MR arthrography is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. MRA Knee MRA is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. MRI Knee MRI is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. Radiography Knee With one or more positive Ottawa rule criteria, including focal tenderness and/or inability to bear weight, radiographs should be the initial imaging modality for the evaluation of acute trauma to the knee [5,6,8].
Acute Trauma to the Knee. In this study, both the Ottawa and Pittsburgh rules showed high sensitivity in detecting knee fractures [5]. Other clinical decision criteria were tested. In an emergency department, in a study of 242 patients >17 years with isolated knee injuries sustained 24 hours previously, Weber et al [3] were able to exclude clinically significant fractures in patients >18 years who could walk without limping or if there was a twisting injury to the knee and no joint effusion. These clinical decision rules were effective in detecting knee fractures with 100% sensitivity and with sufficient specificity to eliminate 29% of knee radiographs [3]. Bone Scan with SPECT or SPECT/CT Knee Tc-99m bone scan with single-photon emission computed tomography (SPECT)/CT knee is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. US Knee US is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. Variant 2: Adult or child 5 years of age or older. Fall or acute twisting trauma to the knee. One or more of the following: focal tenderness, effusion, inability to bear weight. Initial imaging. CT Knee CT is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. MR Arthrography Knee MR arthrography is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. MRA Knee MRA is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. MRI Knee MRI is not routinely used as the initial imaging study for the evaluation of acute trauma to the knee. Radiography Knee With one or more positive Ottawa rule criteria, including focal tenderness and/or inability to bear weight, radiographs should be the initial imaging modality for the evaluation of acute trauma to the knee [5,6,8].