Clinical decision rules discriminate between XXXX and nonfractures in acute isolated knee @entity130 .

@entity1 @entity174 @entity3331 @entity2613 @entity130
STUDY OBJECTIVE: To develop criteria that optimize clinical decisionmaking in the use of radiography after isolated knee @entity130 in adults. DESIGN: A prospective survey of emergency department @entity1 over a 7-month period. Standardized data forms were completed by emergency physicians, residents, and certified physician assistants. SETTING: A large suburban community teaching hospital. @entity1 : Two hundred forty-two @entity1 older than 17 years with isolated @entity3331 sustained less than 24 hours previously. RESULTS: We constructed a clinical decision model, calculating sensitivity, specificity, and odds ratios. Twenty-eight @entity1 (11.6%) had @entity174 , with the patella the most commonly fractured osseous structure. @entity1 able to walk without limping had not experienced a @entity174 , nor had @entity1 with twist injuries without effusion. Sensitivity of this model for detecting @entity174 was 1.0 (99% confidence interval, .97 to 1.0), and specificity was .337 (99% confidence interval, .26 to .42). CONCLUSION: Clinical decision rules are effective in detecting knee @entity174 with 100% sensitivity and with sufficient specificity to eliminate 29% of knee radiographs in the @entity2613 . These findings require prospective validation.
