Ottawa rules

Ottawa ankle rules

The Ottawa ankle rules (OAR) are a set of guidelines to help the physician as to decision making regarding need for x ray examination after ankle and mid-foot injury.^[1]

The Ankle Rules: Order ankle radiographs only if any one of the following exist;^[2]

1. Inability to bear weight for four steps, both immediately and in the Emergency Department.

2. Bone tenderness at the posterior edge or distal 6 cm of either medial or lateral malleolus

Ottawa foot rules

Order foot radiographs only if the patient has foot pain and either of the following:^[3]

1. Inability to bear weight for four steps, both immediately and in the Emergency Department.

2. Bone tenderness at the navicular or base of the fifth metatarsal

Ottawa knee rules

Order knee radiographs only if the patient has knee pain and any of the following: 1. Age 55 years or older 2. Isolated tenderness of the patella 3. Tenderness over the head of the fibula 4. Inability to flex to 90° 5. Inability to bear weight for four steps, both immediately and in the ED

1. ^ http://adc.bmj.com/content/90/12/1309.extract
2. ^ http://www.bmj.com/cgi/content/full/326/7386/417#F1 see introduction
3. ^ http://www.bmj.com/cgi/content/full/326/7386/417#F1 see introduction