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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
A joint space of between 1.5 and 4 mm is regarded as normal. [15] Ankle osteoarthritis. For the ankle, the Kellgren–Lawrence scale, as described for the hip, has been recommended. [16] The distances between the bones in the ankle are normally as follows: [17] Talus - medial malleolus: 1.70 ± 0.13 mm; Talus - tibial plafond: 2.04 ± 0.29 mm
The most common knee problems are: soft tissue inflammation, injury, or osteoarthritis. The mechanism of the knee injury can give a clue of the possible structures that can be injured. For example, applying valgus stress on the knee can cause medial collateral ligament rupture, meanwhile a varus force can cause lateral collateral ligament rupture
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However, from a practical point of view, false positives that lead to negative X-ray tests were the very thing that the knee rules are trying to address. Nonetheless, the Pittsburgh knee rules offer fewer false positives than do the Ottawa knee rules , though the Ottawa knee rules are more commonly used. [ 2 ]
A knee X-ray and/or blood test – this can assist to exclude certain types of arthritis or inflammation. Magnetic Resonance Imaging – to observe cartilage condition and assess deterioration; Arthroscopy – a low invasive approach to image the inside of the knee joint by inserting an endoscope into the knee joint. [16]