Ankle Injuries – To X-Ray Or Not X-Ray

Winter sport brings with it lots of fun and excitement but it also sees the arrival of many athletes to the Emergency Department of their local hospital for X-ray’s and assessment of whether a bone is broken.

One of the most common presentations to the ED is for an Ankle or Foot Injury, usually as a result of a person having their foot “turn inwards” and then being unable to weight-bear or walk on it. Sometimes a “pop”, “crack” or a “snap” noise is heard at the same time and is almost always followed by immediate swelling around the ankle, particularly to the “outside” part.

So what should you do? Do you need an X-ray? Do you need to wait around in ED for hours only to find out that it’s not broken, just badly “sprained” and you should go see your Physio? Read on to get a good idea of what to do.

OTTOWA ANKLE RULES

Most Physiotherapists, Sports Trainers, Doctors and Allied Health Professionals have an understanding or knowledge of the Ottowa Ankle Rules to help determine if a person needs to get an X-ray. An X-ray may catch a bone fracture but won’t necessarily show up any soft tissue or ligament damage – a CT or MRI scan are more detailed but are much more expensive and most of the time unnecessary.

The Ottowa Ankle Rules state that anyone with pain in the MALLEOLAR ZONES (the Purple area in the diagram below), PAIN at POINTS A, B, C or D, or INABILITY TO BEAR WEIGHT immediately following injury and when seen in ED/GP/Physio Clinic should get an X-ray. If you can put weight through your foot after the injury, don’t have boney pain at the spots noted in the diagram then you probably don’t need an X-ray.

There are occasions where the pain is so severe that a person may not be able to put weight on their foot but an X-ray does not show up a fracture or boney injury, whilst on other occasions a person may still be able to walk on their foot even though there is an undetected fracture in the area.

So come see us here at Aspire Physiotherapy Bunbury and we can check it out and help you make the best decision.