Ankle & Foot Bone, Fracture & Joint Pathology Evidence: confirmed

Ottawa Ankle Rules Special Test

Orthopedic Physical Examination & Clinical Assessment Guide

Ottawa Ankle Rules Orthopedic Special Test

What is it used for?

  • Determining the need for X-rays after acute ankle injury.

How to Perform

  • Palpation: Press on the posterior edge (last 6cm) of the lateral and medial malleoli.
  • Palpation: Press on the base of the 5th metatarsal and the navicular bone.
  • Function: Ask the patient to walk 4 steps (weight bear) immediately after injury and in the clinic.

Interpretation of Results

  • Positive: Pain in specific bony areas OR inability to bear weight indicates a need for X-rays to rule out fracture.

Diagnostic Accuracy

  • High Sensitivity (approaching 100%) for ruling out fractures.

References

  • Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.