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An audit on compliance with the Ottawa Knee Rule in patients with traumatic knee pain
Poster Title: An audit on compliance with the Ottawa Knee Rule in patients with traumatic knee pain
Submitted on 27 Sep 2019
Author(s): Qasim Afzaal, Saad SIddiqui, Amit Shah
Affiliations: University Hospitals of Leicester
This poster was presented at BIR 2019
Poster Views: 1,518
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Poster Information
Abstract: Background
The Ottawa Knee Rule is a clinical decision-making tool which can decipher which patient presenting with traumatic knee pain requires diagnostic imaging. The rule states that knee radiographs are indicated if at least one of the five criteria is met. We sought to assess the compliance to this rule by health professionals at a busy teaching hospital.

A retrospective audit was performed on 134 consecutive adult patients that presented to the Leicester Royal Infirmary A&E with traumatic knee pain and subsequently underwent imaging. The adherence to the Ottawa Knee Rule by referrers was reviewed using the clinical information provided. Patient data was retrieved using ICE Sunquest, PACS and analysed using Microsoft Excel.

134 patients were included in the study, 118 (88%) of these met the criteria and the following abnormalities were detected on radiographs; 19/118 (16%) had evidence of fractures, 20/118 had joint effusions, 3/118 had chondrocalcinosis, 3/118 had soft tissue swelling and 73/118 were found to have no abnormalities. 16/134 (12%) did not meet the criteria but still underwent imaging, no significant abnormalities were demonstrated.

The Ottawa Knee Rule is a highly sensitive clinical decision-making tool which ensures clinical safety by identifying patients with a high possibility of fracture. Its use can minimise the quantity of unnecessary imaging and exposure to radiation. Furthermore, applying this rule can improve patient waiting times and reduce the burden on radiology services. Health professionals should be educated of its use to ensure the recommend 95% adherence rate is met.
Summary: An audit on compliance with the Ottawa Knee Rule in patients with traumatic knee painReferences:
1) The Royal College of Radiologists. iRefer: Making the best use of clinical radiology. T22 Knee trauma: fall/blunt trauma.
2) Yao, K. and Haque, T. (2012). The Ottawa knee rules - a useful clinical decision tool. Aust Fam Physician, 41(4), pp.223-4.
3) Cheung, T., Tank, Y., Breederveld, R., Tuinebreijer, W., de Lange-de Klerk, E. and Derksen, R. (2013). Diagnostic accuracy and reproducibility of the Ottawa Knee Rule vs the Pittsburgh Decision Rule. The American Journal of Emergency Medicine, 31(4), pp.641-645
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