The Ankle Rules–You Don’t Always Have to Get an X-ray!

Brian, Correctional Mental Health Professional. And his ankle.

Back in the days when I worked in the ER, I ordered a lot of unnecessary x-rays.  Ankle x-rays were a particular problem.  Often I was sure that there was no fracture, but I ordered the x-ray anyway because of habit–patients with injured ankles got an x-ray.  That’s just the way it was.

So I loved the Ottawa Ankle Rules when they came out.  The Ottawa Ankle Rules were developed by a group of doctors in (where else?) Ottawa to determine which ankle injuries did NOT need to be x-rayed.  They have been studied many times and have been found to be  accurate.  When used, Ankle Rules can cut the number of ankle x-rays by a third, easy.

The Ottawa Ankle Rules can be even more important in corrections than in the ER.   There, the only downsides to an unnecessary x-ray were expense and time.  But in corrections, x-rays can be a logistical and security nightmare.  So it is good to know when you don’t have to order an x-ray for the inmate who twisted his ankle attempting to dunk the basketball at rec.

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