What are the 4 steps of the Ottawa rules?

point tenderness at posterior edge (of distal 6 cm) or tip lateral malleolus. point tenderness at posterior edge (of distal 6 cm) or tip medial malleolus. inability to weight bear (four steps) immediately after the injury and in emergency department.

What is the Ottawa knee decision rule criteria?

isolated tenderness of the patella. inability to flex knee to 90 degrees. inability to bear weight (defined as an inability to take four steps, ie. two steps on each leg, regardless of limping) immediately and at presentation.

When do you not use Ottawa rules?

age 55 or over isolated tenderness of the patella (no bone tenderness of the knee other than the patella) tenderness at the head of the fibula inability to flex to 90 degrees inability to weight bear both immediately and in the casualty department (4 steps – unable to transfer weight twice onto each lower limb …

Why is it called Ottawa ankle rules?

This list of rules was published in 1992 by a team of doctors in the emergency department of the Ottawa Civic Hospital in Ottawa, Canada. Since the rules were formulated in Ottawa they were dubbed the Ottawa ankle rules by their creators a few years after their development, a title that has stuck.

What is the typical treatment for muscle and tendon injuries?

As an immediate treatment for overuse tendinopathy, doctors and physical therapists often recommend the RICE program: rest, ice, compression, and elevation of the injured tendon. They may also suggest a short course of aspirin, ibuprofen, or other anti-inflammatory drugs to help inflammation and pain.

How do you perform a knee exam?

Procedure Steps

1. Ask the patient to walk.
2. Perform a general inspection.
3. Note the scar over the left knee of this patient.
4. Assess knee joint temperature.
5. Palpate the border of the patella.
6. Palpate the joint lines.
7. Palpate the point of insertion.
8. Tap the patella.

Which of the following is an indication for imaging based on the Ottawa knee rules?

If one of the following is present, radiographs are indicated:

• Age >55 years.
• Isolated patellar tenderness without other bone tenderness.
• Tenderness of the fibular head.
• Inability to flex the knee to 90°
• Inability to bear weight immediately after injury and in the emergency department (4 steps) regardless of limping.

What is the cut off age for the Ottawa ankle rule?

Although they were not originally intended for patients younger than age 18 years, a meta-analysis of 12 studies showed that the Ottawa foot and ankle rules can be reliably used to exclude fractures in children older than age 5 years.

When should I xray my wrist?

Wrist x-rays are indicated for a variety of settings including:

• wrist trauma; see Amsterdam wrist rules. suspected fracture. obvious deformity.
• bony tenderness.
• non-traumatic deformity.
• non-traumatic wrist pain.

What is ankle inversion?

Eversion ankle sprains — occurs when the ankle rolls outward and tears the deltoid ligaments. Inversion ankle sprains — occurs when you twist your foot upward and the ankle rolls inward.

Is it worse to tear a ligament or a tendon?

Tears occur when fibrous tissue of a ligament, tendon, or muscle is ripped. Tears can be a result of the same movements that cause a sprain, however, a tear is a more serious injury. While minor tears can take several weeks to heal, severe tendon and muscle tears may take several months.

What is the specificity of the Ottawa Ankle Rules?

A systematic review of 27 studies by Bachmann et al found the pooled sensitivity of the Ottawa Ankle Rules to be 97.6%, with a median specificity of 31.5%.[8] The pooled negative likelihood ratio for the ankle and midfoot were 0.08 and 0.08 respectively whereas in children it was 0.07.

Who is eligible for the Ottawa knee rule?

Ottawa Knee Rule. Describes criteria for knee trauma patients so low risk as not to warrant knee imaging. The Ottawa Knee Rules should be applied to all patients aged 2 and older with knee pain/tenderness in the setting of trauma. The Ottawa Knee Rules were derived to aid in the efficient use of radiography in acute knee injuries.

Is the Ottawa Sah rule 100% sensitive?

Obviously, for a true rule-out tool, sensitivity is more important, and the Ottawa SAH Rule is 100% sensitive, but the specificity quoted is 15%. What are the implications of that, if any?

How old do you have to be to get Ottawa ankle score?

Picture source: The malleolar and midfoot zones from CDR Ankle Poster. Being a highly sensitive model, not very specific however but applicable from children aged 3 to adults up to the age of 55, the Ottawa score is considered to have very few false negatives and to rule out cases where x-rays are not needed.