According to the Ottawa ankle rules, radiographs are recommended for ankle pain alongside which finding?

• A. Inability to bear weight a few minutes after the trauma
• B. Point tenderness over the distal fifth metatarsal
• C. Prior history of ankle sprain
• D. Point tenderness over the distal 6 cm of the tibia medially

Answer: (D)

The Ottawa ankle rules are a set of guidelines designed to help determine whether an individual with an ankle injury requires an x-ray to assess for possible fractures. One of the key components of these rules is the assessment for point tenderness, specifically at significant anatomical landmarks.

In this case, point tenderness over the distal 6 cm of the tibia medially is indicative of a potential fracture in that area. The presence of this tenderness suggests that there is a significant injury that may not be visible without imaging. Therefore, the recommendation for radiographs is warranted to evaluate for possible fractures, particularly because tenderness in this area can signal serious underlying injuries that could require intervention.

The other options provided, while related to assessing ankle injuries, do not directly align with the Ottawa ankle rules regarding the need for radiography. Inability to bear weight after trauma is also considered but does not specifically indicate the need for imaging as clearly as point tenderness over the defined anatomical landmarks. Point tenderness over the distal fifth metatarsal is related to foot injuries, and prior history of ankle sprains is less relevant in the acute assessment of current injury severity.