A 23-year-old female presents with ankle pain due to a fall while walking on ice 1 hour ago. You watch her limp as she walks into the emergency room. On physical examination, the ankle is erythematous, swollen, and tender to touch
The patient cannot stand on the affected ankle. Range of motion is severely limited on inversion of the ankle. On palpation, there is no pain with pressure on the medial or lateral malleolus. Should this patient be sent for ankle x-rays according to the Ottawa ankle rules?
A. No, the ankle shows no tenderness over the medial or lateral malleolus
B. Yes, the patient is unable to bear weight on the ankle
C. Yes, ankle range of motion is limited
D. No, range of motion of the ankle is not limited in all planes
ANS: B
The following Ottawa rules recommend x-ray of the ankle if either one of the following conditions exist:
Inability to bear weight for four steps (both immediately and in emergency department)
Bone tenderness at posterior edge or tip of either malleolus
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