Ankle and foot
Ottawa ankle rules
- What you examine
- Decision rule on whether a radiograph is needed after an ankle injury.
- Procedure
- Palpate the posterior edge and the tip of both malleoli over the distal 6 cm, plus the base of the fifth metatarsal and the navicular. Have the patient take four steps.
- Positive when
- Tenderness at one of those sites, or an inability to take four steps (neither immediately after the trauma nor in the consulting room).
- What the test is worth
- Sensitivity approaching 100 per cent for clinically relevant fractures, which makes it safe for avoiding radiographs.
- Caution
- The rule does not apply in children under five, in intoxication, or when the examination is distracted by other injuries.
- Body region
- Ankle and foot