Musculoskeletal

Ottawa ankle & foot rules

Separate ankle and midfoot radiograph indications after acute injury.

Intended population: Adults with recent blunt ankle or midfoot injury and a reliable examination.

All responses must reflect a clinician's verified history and examination. An unassessed finding is not an absent finding.
A negative result does not exclude tendon, ligament, proximal fibular, or occult injury. Reassess persistent pain or inability to walk.

Age (years)

Blunt injury within 10 days, reliable examination, not pregnant, no isolated skin injury, and not reassessment of this injury?

Pain in the malleolar zone?

Pain in the midfoot zone?

Sources and scoring references

RANZCR adult ankle trauma rule and eligibility ↗Original Ottawa ankle rule refinement (1993) ↗

Implementation references reviewed October 28, 2026. Verify applicability and unusual or treatment-changing results against the linked references and local guidance.