Is A Foot/Ankle X-Ray Needed? Try The Ottawa Ankle Rules

When looking at the research, as many as 12% of patients going to the emergency room are there due to foot and ankle injuries.  Nearly all of these people have an X-Ray performed however less than 15% of these patients will be positive for fractures.  What is this telling us?  This simply means that greater than 85% of people that present with foot and ankle pain have radiographic imaging unnecessarily.  This exposes the patient to unnecessary radiation as well as increases the wait times in the emergency rooms.  Therefore, certain clinical guidelines have been put in place to determine if a person needs imaging based on physical examination.  One of the most highly researched set of guidelines is known as the Ottawa Ankle Rules.

The Ottawa Ankles Rules are clinical guidelines to determine if patients need to undergo a foot/ankle X-Ray based on physical examination.  A study perform by Wang et al in China discovered that the implementation of the OAR decreased unnecessary radiographs by 31.1%  To read more about this study click here.

It is important that the Ottawa Ankle Rules are more well known among patients.  A common question that I and other Physical Therapists get is, "Do I need an X-Ray?"  These are the guidelines that I personally follow when a patient comes to me with an acute ankle sprain.  I am not suggesting to use these guidelines for self diagnosis among patients however I believe its important for patient education.  It is important for patients to understand that examination techniques are proven in the research community and for them to understand how the examination is performed.  Likewise it is important for physical therapists and other healthcare practitioners to understand the Ottawa Ankle Rules when it comes to decision making.

For more information on the Ottawa Ankle Rules click here

For video demonstration of the Ottawa Ankle Rules here is a video: