The Ottawa Ankle Rules are a clinical decision-making strategy for determining which patients require radiographic imaging for ankle and midfoot injuries.
Request an x-ray for a patient with traumatic ankle pain if they have any of the following:
- (A) point tenderness at posterior edge (of distal 6 cm) or tip lateral malleolus
- (B) point tenderness at posterior edge (of distal 6 cm) or tip medial malleolus
- inability to weight bear (four steps) immediately after the injury and in the emergency department.
Request an x-ray for a patient with traumatic midfoot pain if they have any of the following:
- (C) point tenderness at the base of the fifth metatarsal
- (D) point tenderness at the navicular
- inability to weight bear, i.e. inability to take four steps immediately after the injury and in the emergency department.
Adapted from: Stiell IG, McKnight RD, Greenberg GH, et al. Implementation of the Ottawa Ankle Rules. JAMA 1994; 271:827.
Accessed from the Emergency Care Institute website at https://aci.health.nsw.gov.au/ecat/appendices/ottawa-ankle-adult