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Ottawa knee rule (Stiell 1995). Knee x-ray is indicated when any of: age 55 or older, bone tenderness at the fibular head, isolated patellar tenderness (caller-applied), inability to flex to 90 degrees, or inability to bear weight both immediately after injury and in the emergency department (four steps). One weight-bearing failure alone is not enough. Not a diagnosis of fracture, not the Ottawa ankle or foot rule, and not the Pittsburgh knee rule. magent does not examine the knee.