According to the Ottawa Ankle Rules, radiography is indicated for which scenario?

According to the Ottawa Ankle Rules, radiography is indicated for which scenario?

• A. Pain in the malleolar region with inability to bear weight (4 steps) at evaluation.
• B. Pain in the malleolar region with tenderness at the tip of the malleolus.
• C. Pain in the midfoot with tenderness over the base of the fifth metatarsal.
• D. A limp when weight is transferred to the affected extremity is considered unable to bear weight.

Answer: (A)

The main idea being tested is how the Ottawa Ankle Rules decide when ankle X-rays are needed. The key trigger is an inability to bear weight for four steps after the injury in the malleolar region. This scenario fits that exact criterion, signaling a possible fracture even if the exam is not dramatic. The rule exists to catch occult fractures and prevent unnecessary imaging in minor sprains, so this combination—malleolar pain plus inability to bear weight for four steps at evaluation—offers a practical, highly sensitive hint to image.

The main idea being tested is how the Ottawa Ankle Rules decide when ankle X-rays are needed. The key trigger is an inability to bear weight for four steps after the injury in the malleolar region. This scenario fits that exact criterion, signaling a possible fracture even if the exam is not dramatic. The rule exists to catch occult fractures and prevent unnecessary imaging in minor sprains, so this combination—malleolar pain plus inability to bear weight for four steps at evaluation—offers a practical, highly sensitive hint to image.