Under the Ottawa ankle rules, which finding warrants ankle radiographs?

Under the Ottawa ankle rules, which finding warrants ankle radiographs?

• A. Tenderness at Navicular Bone
• B. Pain Free, Able to Walk Four Steps
• C. Inability to Bear Weight Four Steps
• D. Normal Distal Tibia

Answer: (B)

The key idea is that imaging is guided by weight-bearing ability. In the Ottawa ankle rules, you image the ankle if there is either tenderness at the malleoli or an inability to bear weight for four steps immediately after the injury and in the emergency department. Being able to walk a few steps without pain does not meet the criterion for radiographs. Tenderness at the navicular bone is a criterion for the foot (midfoot) radiographs, not the ankle, so it doesn’t apply to an ankle X-ray decision. A normal distal tibia by itself isn’t a trigger for imaging. Thus, the finding that warrants ankle radiographs is the inability to bear weight for four steps.

The key idea is that imaging is guided by weight-bearing ability. In the Ottawa ankle rules, you image the ankle if there is either tenderness at the malleoli or an inability to bear weight for four steps immediately after the injury and in the emergency department. Being able to walk a few steps without pain does not meet the criterion for radiographs. Tenderness at the navicular bone is a criterion for the foot (midfoot) radiographs, not the ankle, so it doesn’t apply to an ankle X-ray decision. A normal distal tibia by itself isn’t a trigger for imaging.

Thus, the finding that warrants ankle radiographs is the inability to bear weight for four steps.