Acute knee injuries: Use of decision rules for selective radiograph ordering

Family physicians often encounter patients with acute knee trauma, Radiogra phs of injured knees are commonly ordered, even though fractures are found in only 6 percent of such patients and emergency department physicians can usually discriminate clinically between fracture and nonfracture. Decision rules have been developed to reduce the unnecessary use of radiologic studi es in patients with acute knee injury. The Ottawa knee rules and the Pittsb urgh decision rules are the latest guidelines for the selective use of radi ographs in knee trauma. Application of these rules may lead to a more effic ient evaluation of knee injuries and a reduction in health costs without an increase in adverse outcomes.