Which rule is used to determine if imaging is needed for ankle injuries?

• A. Ottawa ankle rules
• B. Hawkins test
• C. Tinel sign
• D. Thompson test

Answer: (A)

Imaging decisions after an ankle injury are guided by a rule-based approach to avoid unnecessary X-rays while catching fractures. The Ottawa ankle rules provide specific criteria to decide when ankle radiographs are needed: if there is pain in the malleolar zone and either tenderness at the posterior edge or tip of the malleolus, or an inability to bear weight for four steps immediately after the injury and again in the emergency department. If none of these criteria are met, imaging is usually not required. This approach helps ensure fractures are not missed while reducing unnecessary radiation and costs. The other options are clinical tests used for different conditions and do not guide imaging decisions for ankle injuries: Hawkins test relates to shoulder impingement, Tinel sign indicates nerve irritation, and Thompson test checks for Achilles tendon rupture.