A 43-year-old female was in a bicycling accident and complains of severe pain of the right foot. The patient limps into the emergency room. On physical examination, there is no point tenderness over the medial or lateral ankle malleolus. There is no foot tenderness except at the base of the fifth metatarsal bone. According to the Ottawa foot rules, should an x-ray of the feet be ordered?

Question

Quizplus · Accepted Answer

The Ottawa foot rules suggest that an x-ray is necessary if there is pain in the midfoot zone and either bone tenderness at the base of the fifth metatarsal or the navicular bone, or if the patient cannot bear weight both immediately and in the emergency department. Since the patient has tenderness at the base of the fifth metatarsal and cannot bear weight, both criteria A and C are met, making an x-ray necessary.

A 43-Year-Old Female Was in a Bicycling Accident and Complains