Pittsburgh knee rules
- 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.
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%.
The false positive result is less important as if the patient is positive, they should receive an Xray to assess for a possible fracture which has a much higher specificity.
The use of the Pittsburgh Knee rules reduces the use of knee radiographs by 52%.
- 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.