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Applies the Ottawa ankle rules: with malleolar zone pain, imaging is needed if there is bone tenderness at a malleolar landmark or the patient cannot take four steps.
Ottawa ankle rules
Radiography indicated if malleolar zone pain plus either tenderness at the posterior edge or tip of either malleolus, or inability to bear weight for four steps
Educational estimate only. Not a substitute for professional clinical judgement, and must not be used to make treatment or dosing decisions.
They have been validated in children over about five years old, but local policy should be followed.
The separate Ottawa foot rules cover the navicular and base of the fifth metatarsal.