clinical tests for justification

Question 1

what is the name of the clinical test used to check if radiography is needed for an elbow injury

Answer 1

elbow extension test

Question 2

what does it mean if the patient can fully extend their elbow in the elbow extension test

Answer 2

it means that it is highly unlikely there is a fracture, no radiography needed

Question 3

what are the justification rules applied for deciding to refer a wrist trauma/wrist pathology to radiography

Answer 3

the Amsterdam Wrist Rules

Question 4

what are the criteria for the Amsterdam Wrist Rules

Answer 4

The Amsterdam Wrist rules are criteria that highly increase the likelihood of a wrist fracture. these include:
increased age
male sex
wrist swelling
wrist tenderness
anatomical snuff box tenderness
visible deformation
tender distal radius on palpation
painful radial deviation

Question 5

what are the justification guidelines put in place when referring for an Ankle X-Ray?

Answer 5

The Ottawa ankle rules

Question 6

what are the Ottawa Ankle Rules

Answer 6

the Ottawa Ankle rules state that if a patient has tenderness in the malleolar zone as well as any one of the following criterion, they are very likely to have a fracture
the criteria include:
over age 55
tenderness in the distal 6cm of the fibula
(lateral malleolar zone)
tenderness in the distal 6cm of the tibia (medial malleolar zone)
tenderness at the 5th metatarsal
tenderness at the navicular
inability to bear weight both immediately after injury and on presentation (cannot take 4 steps)

Question 7

what are the rules applied for justification of Knee x-ray requests?

Answer 7

Ottawa Knee Rules

Question 8

according to the Ottawa Knee rules, what are indications of justified knee x-rays?

Answer 8

patient aged 55 years +
tenderness at fibular head
isolated patellar tenderness
inability to flex the knee 90 degrees
inability to weight bear for at least four steps