Ankle injuries: Ottawa ankle rules: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Ankle injuries: Ottawa ankle rules

Sample item

A 25-year-old has a twisted ankle. She has swelling but no bony tenderness at the posterior edge or tip of either malleolus and can take four steps both at the scene and in the clinic. What is the best decision?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. No radiograph is needed under the Ottawa ankle rules

The Ottawa ankle rules call for radiographs only when there is bone tenderness at the posterior edge or tip of a malleolus or inability to bear weight for four steps. The rules have high sensitivity and reduce unnecessary imaging. She meets none of these criteria.

Option by option

  • A. Ankle cast for six weeks

    Casting is not needed for a sprain without fracture.

  • B. MRI of the ankle

    MRI is not part of the initial work-up of a sprain.

  • C. Immediate ankle radiographs

    Radiographs are indicated only if a criterion is met.

  • D. No radiograph is needed under the Ottawa ankle rules (correct)

    Correct. None of the Ottawa criteria is met, so imaging is not needed.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, No radiograph is needed under the Ottawa ankle rules. The Ottawa ankle rules call for radiographs only when there is bone tenderness at the posterior edge or tip of a malleolus or inability to bear weight for four steps.

Why is "Ankle cast for six weeks" not the answer?

Casting is not needed for a sprain without fracture.

Why is "MRI of the ankle" not the answer?

MRI is not part of the initial work-up of a sprain.

Why is "Immediate ankle radiographs" not the answer?

Radiographs are indicated only if a criterion is met.

What concept does this question test?

It tests Ankle injuries: Ottawa ankle rules in Orthopaedics. The rules have high sensitivity and reduce unnecessary imaging. She meets none of these criteria.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Ankle injuries: Ottawa ankle rules?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.