A 23-year-old female presents with ankle pain due to a fall while walking on ice 1 hour ago. You watch her limp as she walks into the emergency room. On physical examination, the ankle is erythematous, swollen, and tender to touch. The patient cannot stand on the affected ankle. Range of motion is severely limited on inversion of the ankle. On palpation, there is no pain with pressure on the medial or lateral malleolus. Should this patient be sent for ankle x-rays according to the Ottawa ankle rules?

Question

Quizplus · Accepted Answer

The Ottawa ankle rules suggest that an ankle X-ray is necessary if there is pain in the malleolar zone and any one of the following: bone tenderness at the posterior edge or tip of the lateral malleolus, bone tenderness at the posterior edge or tip of the medial malleolus, inability to bear weight both immediately and in the emergency department for four steps. This patient's inability to bear weight on the affected ankle meets the criteria for an X-ray.

A 23-Year-Old Female Presents with Ankle Pain Due to a Fall