Ottawa knee rule - Evidencio
Ottawa knee rule
The Ottawa knee rules were derived to aid in the efficient use of radiography in acute knee injuries.
The rule should be used in patients >2 years of age with knee pain/tenderness following trauma < 7 days ago.
Research authors: Stiell IG, Greenberg GH, Wells GA, McKnight RD, Cwinn AA, Cacciotti T, McDowell I, Smith NA.
Version: 1.12
  • Public
  • Orthopaedics
  • {{ modelType }}
  • Details
  • Validate algorithm
  • Save input
  • Load input
Display
Units

{{section.title}}

Calculate the result

Set more parameters to perform the calculation

Number of Ottawa knee rule criteria met: criteria

{{ resultSubheader }}
{{ chart.title }}
Result interval {{ additionalResult.min }} to {{ additionalResult.max }}

Conditional information


How the Ottawa knee rule should be used:
The Ottawa knee rule was initially developed for patients >18 years of age with knee pain/tenderness following trauma < 7 days ago.1 The rule is sensitive (95-100%) to rule-out fractures, but not specific (19-50%) to suggest who may have a fracture. In a multicenter trial including 750 patients aged 2 to 16 years, Bulloch et al (2003) showed that the Ottawa ankle rule is also valid in children.2

Model performance:
In the derivation study (N=1,047) by Stiell et el (1995), the sensitivity of the Ottawa knee rule was 100% (95% confidence interval [CI], 95% to 100%) and specificity was 54% (95% CI, 51% to 57%).1 In a prospecitve validation (N=1096) by the same group, again a sensitivity of 100% (95% CI, 94% to 100%) was found.3 Upon external validation, independent research groups found sensitivities of 95-100% for clinically significant knee fractures using the Ottawa knee rule, with specificities ranging from 19-50%.4-7

Clinical implications of use:
According to the derivation study and several external validation studies, application of the rule would have led to a 17-49% relative reduction in the use of radiography.1-7 Successful use of the rule (e.g. by triage nurses) could improve patient flow, decrease waiting times, and allow for more efficient and cost-effective patient management.8

References:
1 Stiell IG, Greenberg GH, Wells GA, et al. Derivation of a decision rule for the use of radiography in acute knee injuries. Ann Emerg Med. 1995;26(4):405-13.
2 Bulloch B, Neto G, Plint A, et al. Validation of the Ottawa Knee Rule in children: a multicenter study. Ann Emerg Med. 2003;42(1):48-55.
3 Stiell IG, Greenberg GH, Wells GA, et al. Prospective validation of a decision rule for the use of radiography in acute knee injuries. JAMA. 1996;275(8):611-5.
4 Emparanza JI & Aginaga JR. Validation of the Ottawa Knee Rules. Ann Emerg Med. 2001;38(4):364-8.
5 Seaberg DC, Yealy DM, Lukens T, et al. Multicenter comparison of two clinical decision rules for the use of radiography in acute, high-risk knee injuries. Ann Emerg Med. 1998;32(1):8-13.
6 Jalili M & Gharebaghi H. Validation of the Ottawa Knee Rule in Iran: a prospective study. Emerg Med J. 2010;27(11):849-51.
7 Tigges S, Pitts S, Mukundan S Jr, et al. External validation of the Ottawa knee rules in an urban trauma center in the United States. AJR Am J Roentgenol. 1999;172(4):1069-71.
8 Nichol G, Stiell IG, Wells GA, et al. An economic analysis of the Ottawa knee rule. Ann Emerg Med. 1999;34:438-47.
 

{{ file.classification }}
PRO
Note
Notes are only visible in the result download and will not be saved by Evidencio

This algorithm is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.

Underlying algorithms Part of
Comments
Comment
Please enter a comment
Comments are visible to anyone

Algorithm feedback

No feedback yet 1 Comment {{ model.comments.length }} Comments
On {{ comment.created_at }} {{ comment.user.username }} a no longer registered author wrote:
{{ comment.content }}
logo

Please sign in to enable Evidencio print features

In order to use the Evidencio print features, you need to be logged in.
If you don't have an Evidencio Community Account you can create your free personal account at:

https://www.evidencio.com/registration

Printed results - Examples {{ new Date().toLocaleString() }}

Evidencio Community Account Benefits

With an Evidencio Community account you can:

  • Create and publish your own prediction algorithms.
  • Share your prediction algorithms with your colleagues, research group, organization or the world.
  • Review and provide feedback on algorithms that have been shared with you.
  • Validate your algorithms and validate algorithms from other users.
  • Find algorithms based on Title, Keyword, Author, Institute, or MeSH classification.
  • Use and save prediction algorithms and their data.
  • Use patient specific protocols and guidelines based on sequential algorithms and decision trees.
  • Stay up-to-date with new algorithms in your field as they are published.
  • Create your own lists of favorite algorithms and topics.

A personal Evidencio account is free, with no strings attached!
Join us and help create clarity, transparency, and efficiency in the creation, validation, and use of medical prediction algorithms.

Disclaimer: Calculations alone should never dictate patient care, and are no substitute for professional judgement.
Terms & Conditions | Privacy Policy | Disclaimer | Contact | Refuse cookies |
Evidencio v3.35 © 2015 - 2025 Evidencio. All Rights Reserved