A clinical decision rule in the evaluation of acute knee injuries

Bauer, Steven; Hollander, Judd E.; Fuchs, Susana H.; Thode, Henry C.

doi:10.1016/0736-4679(95)00064-h

Cited by 39 publications

(19 citation statements)

References 11 publications

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“…Urgent referral to a specialist is necessary when there are signs of fracture, acute locked knee or severe pain after patella dislocation at the initial consultation that is likely to be attributed to a trauma [57]. Several clinical decision rules are validated that identify patients with a high risk of fracture [58][59][60]. Diagnostic imaging can also be helpful in establishing the correct diagnosis in non-traumatic knee complaints.…”

Section: Discussionmentioning

confidence: 99%

Effect of routine diagnostic imaging for patients with musculoskeletal disorders: A meta-analysis

Karel¹,

Verkerk²,

Endenburg³

et al. 2015

European Journal of Internal Medicine

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Section: Discussionmentioning

confidence: 99%

Effect of routine diagnostic imaging for patients with musculoskeletal disorders: A meta-analysis

Karel¹,

Verkerk²,

Endenburg³

et al. 2015

European Journal of Internal Medicine

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“…Various studies have compared the Ottawa and Pittsburgh decision rules [11][12][13][14]. In general, the Ottawa ru les are better validated across a wider sample of adult patients.…”

Section: Discussionmentioning

confidence: 99%

X-rays for Acute Knee injuries: pre- and post- Pittsburgh Decision Rules implementation. A district general hospital experience

Ashry

Gamal

Challagundla

et al. 2016

Ortop Traumatol Rehabil

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SUMMARYBackground. We wanted to assess the number of unnecessary radiographs done for acute knee injury patients and the accuracy of the Pittsburgh decision rules.Material and methods. A retrospective observational study was done to look at the acute knee injury patients presented to a district general hospital Accident and Emergency Department from August 2011 till August 2013. We assessed the following parameters: sex, age, mechanism of injury, weight-bearing status and incidence of fractures in patients subjected to plain radiograph. A prospective study was then done from April 2014-August 2014 following implementation of the Pittsburgh decision rules.Results. 24% of the patients had knee X-ray, compared to 72.12% in the first cycle. 36.8% had fracture, compared to 6.1% first cycle, with 66.7 % reduction in x-rays. Pittsburgh decision rules sensitivity was 100% and specificity 85.3%, positive predictive value 45.8% and accuracy 87%.Conclusions. 1. The Pittsburgh decision rules is highly sensitive, specific and accurate in determining the need of X-ray in acute knee Injuries. 2. We found that the Pittsburgh decision rules performs well in our hospital, which coincides with previously published literature.

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“…Despite the large number of children seeking acute medical attention for these injuries, knee fractures are relatively uncommon. In previous studies, fracture rates in adults have ranged from 5-12% and approximately 4 -5% in children (1)(2)(3)(4)(5)(6)(7)(8). Although knee radiographs are routinely obtained in many acute care settings, the low incidence of fractures suggests that much of the associated cost and expense of these evaluations can be avoided (9).…”

mentioning

confidence: 97%

“…Clinical decision rules have been developed for adults with knee injuries (1)(2)(3)(4)(5)(6). The most widely recognized rule is the Ottawa Knee Rule (OKR) (1)(2)(3).…”

mentioning

confidence: 99%