According to the Ottawa Ankle Rules, what is required for ankle film?

The Ottawa Ankle Rules are a clinical decision-making tool that helps determine whether a patient with an ankle or foot injury should undergo radiographic imaging to assess for fractures. According to these rules, any of the following criteria would necessitate obtaining radiographs of the ankle:

• Bone tenderness at the medial malleolus indicates that there may be an injury involving the ankle bones, specifically on the inner side of the ankle. This finding suggests that further investigation is needed to rule out fractures in that area.

• Bone tenderness at the base of the 5th metatarsal points to a potential fracture in the foot, particularly in cases of lateral foot injuries. This area is known for being a common site for fractures, especially in inversion injuries.

• Inability to walk four steps immediately after the injury signifies a significant functional impairment likely due to a fracture or a serious soft tissue injury. This criterion helps identify patients who require imaging to assess possible fractures.

Since all these criteria establish a need for imaging to ensure that any potential fractures are identified, the correct answer includes all of them as indications for ankle film. By using the Ottawa Ankle Rules, healthcare providers can make more informed decisions about managing ankle and foot injuries while avoiding unnecessary imaging when the criteria are not