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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
International Knee Documentation Committee (IKDC) system [10] Grade Findings A No joint space narrowing, defined in this system as at least 4 mm joint space B At least 4 mm joint space, but small osteophytes, slight sclerosis, or femoral condyle flattening C 2–4 mm joint space D < 2 mm joint space
Fairbank's changes describe the radiological changes observed on an AP radiograph of the knee after meniscectomy. [ 1 ] Fairbank identified significant changes including squaring of the femoral condyles , peak eminences, ridging, and joint space narrowing.
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 ]
X-ray of the knee of a 12-year-old male, showing knee effusion of medium severity, marked by black arrows. It displaces the patella anteriorly and extends into the suprapatellar bursa. An X-ray is useful to verify that there is no break or dislocation when there is a history of trauma. May show signs of osteoarthritis.
A Settegast is a standard medical x-ray projection that presents a tangential view of the patella. To acquire such an image the patient is placed in a prone position with the knee flexed at least 90 degrees and the field of view centered on the patellofemoral joint space.
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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]