QuestionSBA
QuestionChoice
Although bruising may occur in ankle fractures, this is not a criterion included in the Ottawa ankle rules.
10034914
c
Severe bruising in the mid-foot zone
QuestionChoice
This is incorrect; according to the Ottawa ankle rules, pain at point D would qualify the patient for an ankle x-ray if there was pain in the mid-foot zone, rather than the malleolar zone.
10034915
d
Point-tenderness at point D on the diagram
QuestionChoice
This is incorrect; the Ottawa ankle rules explicitly state that the criteria for an x-ray involve an inability to weight bear (for 4 steps) both immediately and in the emergency department. Simple pain on walking does not fall into this category.
10034916
e
Pain on walking
QuestionChoice
This is correct. The Ottawa ankle rules state that an ankle X-ray is required if (with malleolar zone pain) there is either tenderness at point A, tenderness at point B, or an inability to weight bear for 4 steps both immediately AND in the emergency department.
10034912
a
Tenderness at point A on the diagram
QuestionChoice
This is incorrect; the Ottawa ankle rules state that an inability to weight bear (for 4 steps) should be present both immediately after the injury and also in the ED - i.e. the onset should not be gradual.
10034913
b
Gradual-onset inability to weight bear after the injury
Concept
Chapter
2693
6103
Ottawa Ankle Rules
Topic
145
Orthopaedics
19386
Tenderness in the malleolar zone of the ankle indicates the need for an X-ray to rule out fractures, as per the Ottawa ankle rules.
Picture
https://www.aafp.org/content/dam/brand/aafp/pubs/afp/issues/2012/0615/p1170-f2.jpg
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Topic
145
Orthopaedics
A 22-year-old man visits the emergency department with severe pain in his left ankle, after he twisted it during a fall while walking on a slippery surface.

On examination, his left ankle is swollen and extremely tender in the malleolar zone of the foot:

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Which of the following would suggest that an ankle X-ray is required?
a