Mehlman Ottawa criteria (ankle)

Question 1

M. Ottawa. why used?
very HY topic.

Answer 1

used to assess probability of ankle fracture and tell us whether we need to order xray or vs supportive care (eg RICE).

Question 2

M. Ottawa. is met criteria –> order x ray.

Answer 2

.

Question 3

M. Ottawa.
what criteria?

Answer 3

Pain in maleolar zone + any of the following:

• tenderness POSTERIOR to lateral/medial malleolus
• tenderness ON THE TIP of the lateral/medial malleolus
• Patient cannot bear weight when walking 4 step.

Question 4

M. Ottawa.
Pain in maleolar zone + any of the following:

• …
• tenderness ON THE TIP of the lateral/medial malleolus
• Patient cannot bear weight when walking 4 step.

Answer 4

tenderness POSTERIOR to lateral/medial malleolus

Question 5

M. Ottawa.
Pain in maleolar zone + any of the following:

• tenderness POSTERIOR to lateral/medial malleolus
• ….
• Patient cannot bear weight when walking 4 step.

Answer 5

tenderness ON THE TIP of the lateral/medial malleolus

Question 6

M. Ottawa.
Pain in maleolar zone + any of the following:

• tenderness POSTERIOR to lateral/medial malleolus
• tenderness ON THE TIP of the lateral/medial malleolus
• ….

Answer 6

Patient cannot bear weight when walking 4 step.

Question 7

M. Ottawa.
25M + twisted ankle + tenderness in malleolar zone + pain in anterior and lateral sides (medial malleolus) + patient CAN bear weight. Tx? best next step?

Answer 7

Supportive
Answer was:
2 days ice –> next BEST step –> use a soft protective brace and early range of motion exercises.

Question 8

M. Ottawa.
25M + twisted ankle + tenderness in malleolar zone + pain in anterior and lateral sides (medial malleolus) + patient CAN bear weight.
what would be WRONG answer?

Answer 8

do xray to rule out fracture

Question 9

M. Ottawa.
40M + played basketball and rolled ankle + pain in anterior lateral malleolus + no pain in posterior + swelling of ankle + patient CAN bear weight. Next best step in management?

Answer 9

RICE

Question 10

M. Ottawa.
40M + played basketball and rolled ankle + pain in anterior lateral malleolus + no pain in posterior + swelling of ankle + patient CAN bear weight. WRONG ANSWER?

Answer 10

to do xray
it does not fulfill Ottawa criteria

Question 11

M. Ottawa.
26F + running rolled ankle + pain in lateral ankle + tenderness in POSTERIOR ankle + can bear weight. Next best step?

Answer 11

to do x ray

has pain in malleolar region+
has pain in posterior

despite can bear weight, patient satisfy two other ottawa criteria