MSK

Ottawa Ankle Rule

Decision rule for acute ankle and foot injury identifying which patients require radiography. Validated in adults and children.

Pain in the malleolar zone

Bone tenderness at posterior edge or tip of lateral malleolus (distal 6 cm)

Bone tenderness at posterior edge or tip of medial malleolus (distal 6 cm)

Pain in the midfoot zone

Bone tenderness at base of 5th metatarsal

Bone tenderness at the navicular

Cannot bear weight (4 steps) both immediately and in ED

Source

Stiell IG, Greenberg GH, McKnight RD, Nair RC, McDowell I, Worthington JR. A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Annals of Emergency Medicine 1992.

PMID 1554175 Ask House about this