Interactive Ottawa Ankle Rule calculator. Requires the calculator gadget.
Usage: {{Ottawa Ankle Calculator}}
Ottawa Ankle Rules
Ottawa Ankle Rule
| Criteria
|
No (0)
|
Yes (+1)
|
| Ankle X-ray is required if there is pain in the malleolar zone AND any of the following:
|
|
| Bone tenderness along distal 6 cm of posterior edge of tibia or tip of medial malleolus
|
1
|
|
| Bone tenderness along distal 6 cm of posterior edge of fibula or tip of lateral malleolus
|
1
|
|
| Inability to bear weight both immediately and in the ED (4 steps)
|
1
|
|
| Foot X-ray is required if there is pain in the midfoot zone AND any of the following:
|
|
| Bone tenderness at the base of the 5th metatarsal
|
1
|
|
| Bone tenderness at the navicular
|
1
|
|
| Inability to bear weight both immediately and in the ED (4 steps)
|
1
|
|
| Positive Criteria
|
/ 6
|
| Interpretation
|
| Score = 0
|
No X-ray needed — Sensitivity 96.4–99.6% for clinically significant fractures.
|
| Score ≥ 1
|
X-ray recommended — Ankle and/or foot x-ray indicated based on positive criteria location.
|
| References
|
- Stiell IG et al. A study to develop clinical decision rules for radiography in acute ankle injuries. Ann Emerg Med. 1992;21:384-390. PMID 1554175.
- Stiell IG et al. Decision rules for radiography in acute ankle injuries: refinement and prospective validation. JAMA. 1993;269:1127-1132. PMID 8433468.
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