🦴

🦶 Ottawa Rules

Ankle & Knee X-ray Decision

🦶 Ankle Injury - X-ray Series Required If:

Bone tenderness at posterior edge or tip of lateral malleolus

Bone tenderness at posterior edge or tip of medial malleolus

Inability to bear weight (4 steps) immediately after injury AND in ED

🦶 Foot Injury - Midfoot X-ray If:

Bone tenderness at base of 5th metatarsal

Bone tenderness at navicular

Inability to bear weight (4 steps) immediately after injury AND in ED

🦵 Knee Injury - X-ray If Any of:

Age ≥55 years

Isolated patellar tenderness

Tenderness at head of fibula

Inability to flex knee to 90°

Inability to bear weight (4 steps) immediately after injury AND in ED

📋 Recommendation

📚 Evidence & Guidelines Class I Recommendation

★★★★★ (1992)

Citation: Stiell IG, Greenberg GH, McKnight RD, et al. A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Ann Emerg Med. 1992;21(4):384-390.

Guideline: ACEP Clinical Policy

📖 View on PubMed

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Clinical decision support only. Use with full assessment.

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