clinical prediction rules/clusters

Question 1

MSK: LE

Ottawa knee rules (6)

indication: fracture rule-out

Answer 1

• > 55 years old
• isolated patellar tenderness
• pibular head tenderness
• inability to flex knee to 90
• inability to bear weight immediately after injury +ER

Question 2

MSK: LE

ottawa ankle rules

indication: fracture rule-out

Answer 2

• tenderness @ post edge of med or lat malleolus
• inability to take 4 steps @ scene or in ER

Question 3

MSK: LE

ottawa foot rules

indication: fracture rule-out

Answer 3

• bone tenderness @ base of 5th met
• bone tenderness @ navicular
• inability to take 4 steps @ scene or in ER

Question 4

wainner’s cluster

cervical radiculopathy

Answer 4

spurlings
rotation > 45 degrees bilat
ULTT
cervical distraction

Question 5

MSK: spine

cluster of Laslett (SIJ)

indication: SIJ dysfunction

hint: this chair doesn’t feel good

Answer 5

sacral Thrust
Compression test
Distraction test
Femoral thrust
Gaeslen’s

Question 6

shoulder impingement cluster

Answer 6

hawkins-kennedy
neer’s
empty can
painful arc

Question 7

canadian c-spine high risk rules

indication: post-traumatic xray

Answer 7

• > 65 y/o
• dangerous MOI
• paresthesia in extremities

Question 8

canadian c-spine low risk rules; last deciding factor…?

indication: post-traumatic xray

Answer 8

• simple rear end MVA
• sitting in ER
• walking post-accident
• absent c-spine tenderness
• delayed pain

can they trun head > 45degress?