🦵 Pittsburgh Knee Rules
UseWhether to X-ray an acute knee injury. Do not mix with Ottawa knee rules.
StrataHigh sensitivity. A negative rule can spare films; be cautious in polytrauma and sensory loss.
LimitsTwisting or overuse injuries are out of scope. · Ottawa items (age ≥55, patella/fibular-head tenderness, flexion <90°)… · Individualise in children and multi-trauma.
SourceSeaberg DC, Jackson R. Clinical decision rule for knee radiographs. Am J Emerg Med 1994;12:541-543
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
Mechanism must be fall/blunt trauma.
When to use
Whether to X-ray an acute knee injury. Do not mix with Ottawa knee rules.
How it works
Applies if fall or blunt trauma AND (age <12 or >50 OR inability to walk four WB steps).
Key points
- Mechanism must be fall/blunt trauma.
- Young/old or cannot walk four steps → films.
- Do not mix with Ottawa knee.
References
- Seaberg DC, Jackson R. Clinical decision rule for knee radiographs. Am J Emerg Med 1994;12:541-543
- Seaberg DC, Yealy DM, Lukens T, Auble T, Mathias S. Multicenter comparison of two clinical decision rules for the use of radiography in acute, high-risk knee injuries. Ann Emerg Med 1998;32:8-13
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Mechanism is a fall or blunt trauma | Yes |
|---|---|
| Age | 35 years |
| Unable to walk four weight-bearing steps | Yes |
→SuggestionObtain knee radiographs
- Age <12 or >50：No
- Cannot walk 4 steps：Yes
| Mechanism is a fall or blunt trauma | No |
|---|---|
| Age | 35 years |
| Unable to walk four weight-bearing steps | No |
→SuggestionRule does not apply (not blunt trauma/fall)
Verification & sources · governance
FAQ
Frequently asked questions
- Does Pittsburgh Knee Rules upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Pittsburgh Knee Rules calculated in practice? Can you show a worked example?
- Inputs: Mechanism is a fall or blunt trauma Yes, Age 35 years, Unable to walk four weight-bearing steps Yes → Result: Suggestion Obtain knee radiographs（Age <12 or >50: No, Cannot walk 4 steps: Yes） Inputs: Mechanism is a fall or blunt trauma No, Age 35 years, Unable to walk four weight-bearing steps No → Result: Suggestion Rule does not apply (not blunt trauma/fall)