Understanding the Ottawa Ankle Rules Assessment
A **clinical decision-making tool** used to determine the need for **X-rays** following an acute ankle or mid-foot injury.
Watch How It's Done
How do I start?
Patient is sitting or supine, immediately after injury.
What happens?
The patient is assessed for specific criteria: **1) Bone Tenderness:** over the posterior edge/tip of the lateral or medial malleolus. **2) Bone Tenderness:** over the navicular bone or base of the 5th metatarsal. **3) Weight Bearing:** inability to bear weight immediately and/or for four steps in the emergency department.
In Plain English
What Does a Positive Result Mean?
If the patient meets **any one of these criteria**, an X-ray is required to rule out a fracture.
Helpful Tip:
This tool is not a special test but a standard guideline with near 100% sensitivity for fractures, preventing unnecessary X-rays.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other ankel Tests
Anterior Drawer of the Ankle
To assess the integrity of the **Anterior Talofibular Ligament (ATFL)**, the most commonly injured ligament in lateral ankle sprains.
External Rotation Stress Test (or Syndesmosis Ligament Test)
To assess the integrity of the **Distal Tibiofibular Syndesmosis** (the 'high ankle sprain' ligaments, including the AITFL and PITFL).
Figure of Eight Method of Measuring Ankle Joint Swelling
To quantitatively measure and track **ankle and foot edema (swelling)** volume over time.
Impingement sign ankle (Anterior Ankle Impingement)
To diagnose **Anterior Ankle Impingement Syndrome** (bony or soft tissue impingement at the front of the joint).