pittsburgh_knee_rules: Pittsburgh Knee Rules

In cliot: Clinical Indices and Outcomes Tools

Pittsburgh Knee Rules

Description

Applies the Pittsburgh Knee Rules to determine the need for knee radiography in patients with acute knee injury. This decision rule is highly sensitive for detecting knee fractures and can reduce unnecessary imaging.

Usage

pittsburgh_knee_rules(blunt_trauma_or_fall, age_years, unable_to_walk_4_steps_in_ed)

Arguments

blunt_trauma_or_fall	Numeric (0 or 1). Did the injury involve blunt trauma or a fall? (1 = Yes). This is the entry criterion for the rule.
age_years	Numeric. Patient age in years.
unable_to_walk_4_steps_in_ed	Numeric (0 or 1). Is the patient unable to walk 4 weight-bearing steps in the emergency department? (1 = Yes).

Details

Imaging is indicated if the mechanism is blunt trauma or fall AND one of the following is met:

• Age < 12 years

• Age > 50 years

• Inability to walk 4 weight-bearing steps in the ED

Value

A list containing:

Recommendation

Guidance on whether a knee X-ray is indicated.

References

Seaberg DC, Yealy DM, Lukens T, Auble T, Mathiasen RA. Multicenter comparison of two clinical decision rules for the use of radiography in acute, high-risk knee injuries. Ann Emerg Med. 1998;32(1):8-13. doi:10.1016/s0196-0644(98)70094-4

Examples

# Example 1: X-ray Indicated (Age)
# Trauma (1), Age 60, Can walk (0)
pittsburgh_knee_rules(1, 60, 0)

# Example 2: X-ray Indicated (Inability to walk)
# Trauma (1), Age 30, Cannot walk (1)
pittsburgh_knee_rules(1, 30, 1)

# Example 3: Not Indicated
# Trauma (1), Age 30, Can walk (0)
pittsburgh_knee_rules(1, 30, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.