Pittsburgh knee rules
The Pittsburgh knee rules are medical rules created to ascertain whether a knee injury requires the use of X-ray to assess a fracture.
Criteria
- Blunt trauma or a fall as mechanism of injury AND either of the following
- Age younger than 12 years or older than 50 years
- Inability to walk four weight-bearing steps in the emergency department.
If the patient satisfies the above criteria, they should receive an X-ray to assess for a possible fracture.
Accuracy
The sensitivity of using the Pittsburgh knee rules is 99% with a specificity of 60%. That means the use of the above rules has a false negative result of 1% and a false positive result of 40%.[1]
The false positive result is less important as if the patient is positive, they should receive an X-ray to assess for a possible fracture, which has a much higher specificity. However, the Pittsburgh knee rules offer less false positives than do the Ottawa knee rules, though the Ottawa knee rules are more commonly used. [2]
The use of the Pittsburgh knee rules reduces the use of knee radiographs by 52%.[3]
See also
References
- ↑ Seaberg DC, Jackson R (1994). "Clinical decision rule for knee radiographs.". Am J Emerg Med 12 (5): 541–3. PMID 8060409.
- ↑ MDCalc. "Pittsburgh Knee Rules". MDCalc. Retrieved 2014-10-15.
- ↑ Tandeter HB, Shvartzman P (December 1999). "Acute knee injuries: use of decision rules for selective radiograph ordering". Am Fam Physician 60 (9): 2599–608. PMID 10605994.
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