Ottawa ankle rules: Difference between revisions
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== | ==Ankle== | ||
X-ray is only required if there is pain in the malleolar zone AND any of these findings: | |||
# Bony tenderness along the posterior edge or distal 6cm of either malleolus | #Bony tenderness along the posterior edge or distal 6cm of either malleolus | ||
#Inability to bear weight for at least two steps with each foot immediately after the injury AND at the time of evaluation | |||
# Inability to bear weight for at least two steps with each foot immediately after the injury | |||
==Foot== | |||
X-ray is only required if there is pain in midfoot zone AND any of these findings: | |||
# Bony tenderness over the navicular bone | #Bony tenderness over the navicular bone | ||
# Bony tenderness over base of the 5th metatarsal | #Bony tenderness over base of the 5th metatarsal | ||
# Inability to bear weight for at least two steps with each foot immediately after the injury | #Inability to bear weight for at least two steps with each foot immediately after the injury And at the time of evaluation | ||
===Exceptions=== | ===Exceptions=== | ||
Revision as of 19:32, 22 April 2011
Ankle
X-ray is only required if there is pain in the malleolar zone AND any of these findings:
- Bony tenderness along the posterior edge or distal 6cm of either malleolus
- Inability to bear weight for at least two steps with each foot immediately after the injury AND at the time of evaluation
Foot
X-ray is only required if there is pain in midfoot zone AND any of these findings:
- Bony tenderness over the navicular bone
- Bony tenderness over base of the 5th metatarsal
- Inability to bear weight for at least two steps with each foot immediately after the injury And at the time of evaluation
Exceptions
- ?age <18 or >55
- doesn't apply to pediatrics
- only for blunt trauma mechanism
- doesn't apply to subacute/chronic injuries
- doesn't apply to injuries of the hindfoot or forefoot
0.5% of pt's not xrayed were found to have minor fractures on follow up xray in 5-7 days.
Although it doesn't apply to peds, a study of 1500 patients age 1-15 showed a sensitivity of 98% (Journal of Acc/Emerg Med 1999;16:342-344)