- Ankle radiography was the third most common study ordered in the emergency department.
- Majority of patients with ankle radiographs did not receive adequate physical examination before radiographs were obtained.
- Only 17% of extremity radiographs obtained had abnormality that would alter treatment.
Guidelines for Obtaining Ankle Radiographs (Ottawa Rule)
- Inability to bear weight immediately after the injury OR
- Point tenderness (over medial malleolus, posterior edge or inferior tip of lateral malleolus, talus, calcaneus) OR
- Inability to ambulate for four steps in the emergency room
Decrease number of ankle and midfoot radiographs by 19% - 36%
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ACR Appropriateness Criteria "Suspected Ankle Fracture", revised 2005.