Acute ankle and knee injuries: to x-ray or not?

Acute injuries to the ankle and knee joints are common and patients usually present to an emergency department or a general practice. Differentiating soft tissue injuries from fractures is important because the management of these two groups differ. Medical practitioners are becoming increasingly aware of the accumulative effects of x-rays and there is a move to minimise x-ray exposure, especially in younger patients. Clinical tools have been developed to help clinicians target x-rays to those patients who are likely to have a fracture and not those that almost certainly do not. Such clinical tools or rules must have a very high sensitivity and reasonable specificity to be helpful.

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