Pittsburgh knee rules
The Pittsburgh knee rules are a clinical decision-making strategy for determining which patients require radiographic imaging for knee pain.
A patient with knee pain qualifies for a radiograph if:
- fall or blunt trauma
- <12 years old or >50 years old
- inability to take four steps, regardless of age
The original formulation of the Pittsburgh knee rules stated 100% sensitivity and 79% specificity for detection of fracture 1.
The Pittsburgh knee rules are often thought of in the context of the Ottawa knee rules. Some believe the Pittsburgh knee rules offer increased specificity 2.
- 1. Seaberg DC, Jackson R. Clinical decision rule for knee radiographs. Am J Emerg Med. 1994;12 (5): 541-3. Pubmed citation
- 2. Cheung TC, Tank Y, Breederveld RS et-al. Diagnostic accuracy and reproducibility of the Ottawa Knee Rule vs the Pittsburgh Decision Rule. Am J Emerg Med. 2013;31 (4): 641-5. doi:10.1016/j.ajem.2012.11.003 - Pubmed citation