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Emergency medicine

Acute ankle and knee injuries: to x-ray or not?

Gordian Fulde

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Abstract

The Ottawa ankle and knee rules are validated clinical decision tools that guide clinicians in targeting radiology to those patients who are likely to have an ankle or knee fracture, thus minimising x-ray exposure of patients and reducing costs.

Article Extract

Acute injuries to the ankle and knee joints are common and patients usually present to an emergency department or a general practice. Differentiating soft tissue injuries from fractures is important because the management of these two groups differ. Medical practitioners are becoming increasingly aware of the accumulative effects of x-rays and there is a move to minimise x-ray exposure, especially in younger patients. Clinical tools have been developed to help clinicians target x-rays to those patients who are likely to have a fracture and not those that almost certainly do not. Such clinical tools or rules must have a very high sensitivity and reasonable specificity to be helpful.

Picture credit: © Photo Researchers/Getty Images.

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