Ottawa Ankle Rules

Does this ankle injury require an x-ray?

The global unit selector only affects unanswered questions
1.Inability to weight bear (4 steps) both immediately and in the Emergency department?
2.Bony tenderness on posterior 6cm of Lateral Malleolus?
3.Bony Tenderness on posterior 6cm of Medial Malleolus?
4.Tenderness at base of 5th Metatarsal?
5.Pain at Navicular Bone?
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1. Inability to weight bear (4 steps) both immediately and in the Emergency department?

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About this Calculator

The Ottawa ankle rules have been validated in adults with 100% Sensitivity.

In children ages 1-15 the Ottawa Ankle rules have been validated with 98-100% Specificity and 36-47% Sensitivity for clinically significant ankle injuries, however other studies have suggested lower sensitivity rates. Clinical judgment should be used in younger children.


Libetta et al.

Validation of the Ottawa ankle rules in children.

Journal of Accident & Emergency Medicine 1999, 16 (5): 342-4

Plint et al.

Validation of the Ottawa Ankle Rules in children with ankle injuries.

Academic Emergency Medicine 1999, 6 (10): 1005-9

Stiell et al.

Decision rules for the use of radiography in acute ankle injuries. Refinement and prospective validation.

JAMA: the Journal of the American Medical Association 1993 March 3, 269 (9): 1127-32

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