Ottawa Ankle Rules
Ottawa Ankle and Foot Rules (Stiell 1992): ankle x-ray if malleolar-zone pain plus posterior-malleolus tenderness or inability to bear weight.
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Example
- Pain in malleolar zone
- Yes
- Lateral malleolus tenderness
- Yes
- Medial malleolus tenderness
- No
- Ankle: cannot bear weight 4 steps
- Yes
- Pain in midfoot zone
- No
- Base of 5th metatarsal tenderness
- No
- Navicular tenderness
- No
- Foot: cannot bear weight 4 steps
- No
Result: Ankle x-ray indicated per Stiell 1992.
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What the result means
- no criteria
- No imaging indicated by Ottawa Ankle Rules per Stiell 1992.
- ankle criteria met
- Ankle x-ray indicated per Stiell 1992.
- foot criteria met
- Foot x-ray indicated per Stiell 1992.
What you enter
- Pain in malleolar zone
- Lateral malleolus tenderness (distal 6 cm)
- Medial malleolus tenderness (distal 6 cm)
- Ankle: cannot bear weight 4 steps
- Pain in midfoot zone
- Base of 5th metatarsal tenderness
- Navicular tenderness
- Foot: cannot bear weight 4 steps
How this is calculated
Stiell IG, Greenberg GH, McKnight RD, Nair RC, McDowell I, Worthington JR. A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Ann Emerg Med. 1992;21(4):384-390. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.