Do I Need An X-ray? Simple Ankle And Foot Rules

Ankle injuries are one of the most common injuries in sports and recreational activities. An x-ray is useful in determining whether there is a bony injury like a fracture or broken bone. Some simple rules (Ottawa ankle rule) can be helpful in deciding if you need to get x-rays.

An ankle x-ray is only required if:

There is pain in the malleolar zone area highlighted and any of the following:

1. Tenderness on the bone at A.
2. Tenderness on the bone at B
3. You are unable to bear weight immediately for at least 4 steps

A foot x-ray is only required if:

There is pain in the midfoot zone highlighted areas and any of the following:

1. Tenderness on the bone at C
2. Tenderness on the bone at D
3. You are unable to bear weight immediately for at least 4 steps

Also, if you notice any deformity of the ankle or foot; a significant difference between the bony alignment of one ankle or foot compared to the other, x-rays should be taken immediately.

If the above rules do not apply to you but you are still having significant pain, swelling, weakness, or a sensation that the ankle or foot is giving away, physical therapy may be for you. A physical therapist can perform a thorough physical evaluation and in most cases determine the most appropriate course to manage your symptoms and get you back to feeling 100%. In Minnesota, physical therapy can be accessed without a physician’s referral unless your insurance requires it. Feel free to make an appointment with me if you’d like some additional help.