Purpose: The Ottawa Knee Rules were developed in order to determine the need for radiographs after acute knee injury secondary to the risk of fracture.


1. Age > 55
2. Tenderness at the head of the fibula
3. Isolated tenderness of the patella during palpation
4. Inability to flex the knee to 90 degrees
5. Inability to bear weight immediately and upon ER evaluation


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1. Bachmann LM, Haberzeth S, Stuerer J, ter Riet G. The accuracy of the Ottawa Knee Rule to rule out knee fractures: a systematic review. Ann Intern Med. 2004; 140: 121–124.

2. Vijaysankar D, Boyle AA, Atkinson P. Can the Ottawa Knee Rule be applied to children? A systematic review and meta analysis of observational studies. Emerg Med J. 2009; 26: 250-253.

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