# Ottawa Knee Rules Protocol

## Summary

The Ottawa Knee Rules are a set of guidelines to help determine the need for X-ray imaging in patients with acute knee injuries. These rules are designed to identify fractures and reduce unnecessary radiography. The decision-making process involves assessing specific criteria related to patient age, tenderness, knee flexion, and weight-bearing ability.

## Acute Knee Injury Evaluation

1. **Patient aged 55 years or over?**
    - **Yes:** Knee X-ray indicated
    - **No:** Assess tenderness at the head of the fibula

2. **Tenderness at the head of the fibula?**
    - **Yes:** Knee X-ray indicated
    - **No:** Assess isolated tenderness of the patella

3. **Isolated tenderness of the patella?**
    - **Yes:** Knee X-ray indicated
    - **No:** Assess ability to flex knee to 90 degrees

4. **Ability to flex knee to 90 degrees?**
    - **Yes:** Assess ability to bear weight immediately and at presentation
    - **No:** Knee X-ray indicated

5. **Can bear weight immediately and at presentation?**
    - **Yes:** No X-ray indicated
    - **No:** Knee X-ray indicated