Ottawa knee, ankle and foot rules
01 February 2010
The Ottawa knee, ankle and foot rules are a guideline for doctors to aid them in deciding if a patient with foot or ankle pain should be offered X-rays to diagnose a possible bone fracture.
Ottawa ankle and foot rules
An ankle x-ray is required only if there is any pain in malleolar zone and any of these findings:
- bone tenderness at A
- bone tenderness at B
- inability to weight bear both immediately and in the casualty department.
A foot x-ray is required if there is any pain in the midfoot zone and any of these findings:
- bone tenderness at C
- bone tenderness at D
- inability to weight bear both immediately and in the casualty department.
Ottawa knee rules
A knee x-ray is only required for knee injury patients with any of these findings:
- age 55 or over
- isolated tenderness of the patella (no bone tenderness of the knee other than the patella)
- tenderness at the head of the fibula
- inability to flex to 90 degrees
- inability to weight bear both immediately and in the casualty department (4 steps - unable to transfer weight twice onto each lower limb regardless of limping).
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