Subjects:
Emergency Medicine, Health Briefs
Topics:
ankle injuries, clinical decision rules, diagnostic radiologic examination

♦ Boutis K, et al. CMAJ. Aug. 19, 2013, www.cmaj.ca/content/early/2013/08/12/cmaj.122050.full.pdf.

Boutis K, et al. Lancet. 2001;358:2118-2121.

Pediatricians can use the Low Risk Ankle Rule to identify clinically significant pediatric ankle fractures and help avoid unnecessary X-rays.

Use of a validated clinical decision rule for pediatric ankle injuries led to a significant reduction in the rate of radiography with no associated increase in clinically important fractures being missed, according to a study of 2,151 children treated at six emergency departments (EDs) in Canada.

Studies have shown that X-rays are ordered for up to 95% of children who present to EDs with ankle injuries, but only 12% have a fracture. As a result, many children are exposed unnecessarily to radiation, and resources are wasted.

The Low Risk Ankle Rule has been shown to have a sensitivity of 100% in identifying clinically significant pediatric ankle fractures. According to the rule,...

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