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How do I know if I need an x-ray of my injured ankle?

Typically an x-ray would be ordered based on your doctor’s findings during the examination of your injured ankle. Tenderness directly on a boney area is usually a strong indication for an x-ray.

X-rays are an excellent tool for making sure that there is not a broken bone (a.k.a., fracture). Is there an obvious difference in appearance between the injured ankle and the uninjured ankle? If so you will want to get an x-ray immediately. If there is no obvious deformity, it can be tough to know if an x-ray is necessary, but there is a set of guidelines (called the Ottawa ankle rules) that can be followed to decide if you need an x-ray.

Ottawa ankle rules:
  • The inability to walk four steps both immediately and following the injury and at the time of examination.
  • Pain is felt when the back half of the malleolus (the ball looking bones on each side of your ankle), or six centimeters above or below the malleolus, is touched.
  • Pain is felt on the outside (little toe side) of your foot, specifically the 5th metatarsal, or on top of the foot close to where your heel is (the navicular bone).
If you are concerned about a broken bone, you can always go to a physician or orthopedist educated in the field of injuries. These experts will be able to give you sound advice on what you should do. (This answer provided for NATA by the Eastern University Athletic Training Education Program)

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.