From the British Columbia Council on Clinical Practice (July 1996)
Submitted by: Liz Harrison Ph.D., Dip. Sport (PT)

Your doctor has examined your injured ankle according to the Ottawa Ankle Rules. These rules, tested on thousands of individuals, have been reviewed and adopted for use in British Columbia by the British Columbia Council on Clinical Practice Guidelines. The Ottawa Ankle Rules provide recommendations to help your doctor decide when to x-ray an injured ankle.

The recommendations advise your doctor to perform an x-ray only when:

  1. You experience pain in the ankle (Zone I) and any of the following:
    • bone tenderness at A; or
    • bone tenderness at B; or
    • you are unable to bear weight both immediately and in the emergency department.
  2. You experience pain in the foot (Zone II) and any of the following
    • bone tenderness at C; or
    • bone tenderness at D; or
    • you are unable to bear weight both immediately and in the emergency department.

anklepat

Your doctor will provide you with instructions about how to care for your injured ankle. If your symptoms do not improve as expected please return to your doctor for further care.

About X-rays for Ankle Injury
Every year over 135,000 ankle and foot x-rays are performed in British Columbia. Fewer than 15% of these x-rays reveal a significant fracture. Based on the Ottawa Ankle Rules, the above guidelines provide recommendations that allow physicians to safely rule out instances where an x-ray will not show a fracture. This, in turn, can save you waiting time and help you avoid unnecessary exposure to radiation.

Guidelines, such as the Ottawa Ankle Rules, prevent expenditure on unnecessary health care services while ensuring that you undergo only those procedures that will be of proven benefit.