cliot (version 1.0.0)

pittsburgh_knee_rules: 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)

Value

A list containing:

Recommendation

Guidance on whether a knee X-ray is indicated.

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

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)