The Ottawa ankle rule is an effective tool to determine the use of radiography for acute ankle injuries.
These rules is validated in both adults and children.
It has a high sensitivity of 90%-100% and has clinical significance to rule out foot fracture but has poor specificity for ruling in foot fractures ( many false positives).
Some points to consider when carrying the assessment:
Palpate the entire distal 6cm of the fibula and tibia;
Do not neglect the importance of medial malleolar tenderness;
“Bearing weight” counts even if the patient limps;
