Updated Ottawa Ankle

Question 1

An ankle x ray is only required if

Answer 1

• 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 tibia or tip of the medial malleolus
• bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus
• an inability to bear weight both immediately and in ER for four steps

Question 2

A foot x ray series us indicated if (2)

Answer 2

There is any pain in the midfoot zone and any one of the following:
- bone tenderness at the 5th metatarsal (for foot injuries)
- bone tenderness at the navicular bone (for foot injuries)
- an inability to bear weight both immediately and in the ED for 4 steps