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The Ottawa knee rules are a set of rules used to help physicians determine whether an x-ray of the knee is needed.[1]

They state that an x-ray is required only in patients who have an acute knee injury with one or more of the following:

  • Age 55 years or older
  • Tenderness at head of fibula
  • Isolated tenderness of patella
  • Inability to flex to 90°
  • Inability to bear weight both immediately and in the emergency department (4 steps)

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