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Table 1 The Ottawa ankle rules (4).

From: Review for the generalist: evaluation of pediatric foot and ankle pain

An ankle x-ray series is only necessary if there is pain in the malleolar zone and any of the following:
1. Bone tenderness at the posterior edge or tip of the lateral mallelous, or
2. Bone tenderness at the posterior edge or tip of the medial mallelous, or
3. Inability to weight bear both immediately and in the emergency department
A foot x-ray series is only necessary if there is pain in the midfoot zone and any of the following:
1. Bone tenderness at the base of the 5th metatarsal, or
2. Bone tenderness at the navicular bone, or
3. Inability to weight bear both immediately and in the emergency department