Have you rolled over on your ankle or injured your foot? It’s more than likely sore, swollen and a combination of glorious colours!

How do you know if it’s just a sprain (soft tissue injury) or if there may be a fracture (bone break) involved?

As clinicians there are a set of guidelines which we use as a screening test to help guide our decision making in whether or not to refer for an x-ray after an ankle/foot injury. These are called the Ottawa Ankle Rules.

Going by these these rules:

An ankle x-ray is required if there is pain around the ankle area AND:

• You are unable to put weight through the leg for 4 steps after the injury occurs (walking with a limp is okay).

OR

• You are tender on either of the sticky-out bony bumps located either side of the ankle (particularly towards the rear of these bone bumps) or any bony tenderness above or below these bumps.

A foot x-ray is required if there is pain around the middle of the foot AND:

• You have tenderness over the sticky-out bony bump on the outside of your foot (located about halfway between the outside of your heel and your little toe).

OR

• You are unable to put weight through the leg for 4 steps after the injury occurs (a limp is okay)..

OR

• You have tenderness over the bony bump on the inside of your foot (a few centimetres in front of the bony bump on the inside of your ankle).

It is important to note that these guidelines are for clinicians to combine with their own assessment and clinical reasoning skills. They should not replace an assessment by a medical professional nor medical advice. These guidelines purely act as screening test to help us rule out the possibility of an ankle/foot fracture.

Information based on:

http://www.theottawarules.ca/ankle_rules