Ottawa ankle & foot rules
Whether an ankle/foot X-ray is needed after injury.
What it is for
Acute ankle/foot trauma — the published decision rule (near-100% sensitive for fracture). Each criterion is shown; the rule is met only as the zone headings state.
Use the working calculator
The working Ottawa ankle & foot rules calculator is on our calculators page. It is free and needs no account. Enter the values and it shows the result with the reading that goes with it.
The calculators are free. The trial opens the protocols and pathways they link to.What you enter
The calculator asks for 7 items.
Ankle X-ray — pain in the malleolar zone AND any of:
- Pain in malleolar zone
- Bony tenderness — posterior edge / tip of lateral malleolus (distal 6 cm)
- Bony tenderness — posterior edge / tip of medial malleolus
Foot X-ray — pain in the midfoot zone AND any of:
- Pain in midfoot zone
- Bony tenderness — base of 5th metatarsal
- Bony tenderness — navicular
Either region:
- Unable to weight-bear 4 steps (both immediately and now)
How the result is read
The result is shown as X-ray indication.
The calculator reports one of these readings, with the action that goes with it: Ankle + foot X-ray; Ankle X-ray indicated; Foot X-ray indicated; No X-ray needed.
Sources
These are the sources the calculator cites. Check the current version before relying on a threshold.
Related
For qualified clinicians. A score supports a clinical decision and does not make it: check the inputs, read the cited source, and use the tools in your clinical system for patient care where one is provided.