Ottawa Ankle and Knee Rules
Clinical decision rules to guide radiography in ankle and knee injuries. Highly sensitive for fracture; reduces unnecessary imaging.
Score interpretation
No Ottawa criterion met.
→ No radiograph needed; soft-tissue injury likely; safety-net advice and review if not improving.
At least one Ottawa criterion met.
→ Obtain the appropriate radiograph to rule out fracture.
Interpretation bands for the Ottawa Rules. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Ibuprofen (Orthopaedic Musculoskeletal Pain) · NSAID — Non-selective COX Inhibitor
- Dexketoprofen (Acute Musculoskeletal Pain) · NSAID — Non-selective COX Inhibitor (S-enantiomer of Ketoprofen)
- Co-amoxiclav (Open Fracture Antibiotic Prophylaxis) · Beta-lactam / Beta-lactamase Inhibitor Combination
- Piperacillin-Tazobactam (Polymicrobial Open Fracture Infections) · Extended-spectrum Beta-lactam / Beta-lactamase Inhibitor
- Hip Fracture Pathway · NICE CG124; BPT
- Cauda Equina Syndrome · Society of British Neurological Surgeons; BOA — Best Practice
- Knee Soft Tissue Injury (ACL / MCL / Meniscus) · BOA; Royal College of Surgeons
- Shoulder Dislocation · BOA; RCEM
- Scaphoid Fracture · BOA; BSSH
- Pelvic Fracture · BOA; ATLS; NICE NG39
Featured in these MRCEM clinical pathways
The Ottawa Rules is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.