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Journal Abstract
X-rays for Acute Knee Injuries: Pre- and Post- Pittsburgh Decision Rules Implementation. A District General Hospital Experience
Saad R. El Ashry, Tarek A. El Gamal, Sudhakar R. Challagundla, Chara A. Ntala, Ahmed M. Nagy, Evan O. Crane
Ortop Traumatol Rehabil 2016; 18(5):470-475
ICID: 1226277
Article type: Original article
IC™ Value: 3.00
Abstract provided by Publisher
Background. We wanted to assess the number of unnecessary radiographs done for acute knee injury patients and the accuracy of the Pittsburgh decision rules.
Material and methods. A retrospective observational study was done to look at the acute knee injury patients presented to a district general hospital Accident and Emergency Department from August 2011 till August 2013. We assessed the following parameters: sex, age, mechanism of injury, weight-bearing status and incidence of fractures in patients subjected to plain radiograph. A prospective study was then done from April 2014- August 2014 following implementation of the Pittsburgh decision rules.
Results. 24% of the patients had knee X-ray, compared to 72.12% in the first cycle. 36.8% had fracture, compared to 6.1% first cycle, with 66.7 % reduction in x-rays. Pittsburgh decision rules sensitivity was 100% and specificity 85.3%, positive predictive value 45.8% and accuracy 87%.
Conclusions. 1. The Pittsburgh decision rules is highly sensitive, specific and accurate in determining the need of X-ray in acute knee Injuries. 2. We found that the Pittsburgh decision rules performs well in our hospital, which coincides with previously published literature.

ICID 1226277

DOI 10.5604/15093492.1226277
PMID 28102159 - click here to show this article in PubMed

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