Ottawa Ankle Rules
Other Names
- Ottawa Foot Rules
- Ottawa Ankle Rules
- Ottawa ankle criteria
- Ottawa foot and ankle rules
- Ottawa rules for ankle injuries
- Ankle fracture decision rule (Ottawa)
Purpose
- Decision making tool to determine if radiographs are indicated for acute, traumatic foot or ankle pain
- Assesses Medial Malleolus, Lateral Malleolus, 5th Metatarsal, Navicular
Description
An Ankle X-ray is only required if:
- There is any pain in the malleolar zone; and,
- Any one of the following:
- Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus, OR
- Bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus, OR
- An inability to bear weight both immediately and in the emergency department for four steps.
A Foot X-ray series is indicated if:
- There is any pain in the midfoot zone; and,
- Any one of the following:
- Bone tenderness at the base of the fifth metatarsal (for foot injuries), OR
- Bone tenderness at the navicular bone (for foot injuries), OR
- An inability to bear weight both immediately and in the emergency department for four steps.
Pathology
Evidence
Fractures of the Ankle and Foot
- Bachman et al[1]
- Sensitivity: 97.6%
- Specificity: 31.5%
See Also
References
- ↑ 1.0 1.1 Bachmann LM, Kolb E, Koller MT, Steurer J, ter Riet G. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326(7386):417.
- ↑ Kose, Ozkan, et al. "Comparison of Ottawa ankle rules and Bernese ankle rules in acute ankle and midfoot injuries." Turk J Emerg Med 3 (2010): 101-103.
- ↑ Gomes, Yolanda E., et al. "Diagnostic accuracy of the Ottawa ankle rule to exclude fractures in acute ankle injuries in adults: a systematic review and meta-analysis." BMC musculoskeletal disorders 23.1 (2022): 885.
Created by:
John Kiel on 7 August 2019 14:30:55
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Last edited:
22 March 2026 15:15:13
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