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Review: several diagnostic aids have moderate to high accuracy for detecting abnormalities in acute knee pain

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 Q What is the accuracy of clinical decision rules (CDR), physical examination (PE), and imaging procedures (eg, magnetic resonance imaging [MRI]) for detecting causes of acute knee pain?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Emergency medicine ★★★★★☆☆


Embedded ImageData sources:

Medline (1966 to October 2002) and bibliographies of relevant articles.

Embedded ImageStudy selection and analysis:

peer reviewed studies that evaluated CDR for fractures of the knee, or compared PE and MRI with arthroscopy (reference standard) for detecting meniscal and ligamentous knee damage.

Embedded ImageOutcomes:

sensitivity and specificity, and negative and positive likelihood ratios.


(1) CDR for ruling out knee fractures. Of the 4 CDR evaluated (1 study each), the Ottawa knee rules had the most thorough validation (sensitivity 100%, 95% CI 94 to 100; specificity 49%, …

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  • For correspondence: Dr J L Jackson, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

  • Source of funding: not stated.