{"id":1848,"date":"2016-03-01T12:26:42","date_gmt":"2016-03-01T12:26:42","guid":{"rendered":"https:\/\/andreasphysioblog.com\/?p=1848"},"modified":"2021-05-21T14:25:22","modified_gmt":"2021-05-21T14:25:22","slug":"ankle-testing-ottowa-rules-the-anterior-drawer-and-talar-tilt-tests-syndesmosis-and-deltoid-ligaments","status":"publish","type":"post","link":"https:\/\/andreasphysioblog.com\/?p=1848","title":{"rendered":"Ankle testing. Ottowa Rules, The anterior drawer and talar tilt tests, syndesmosis and deltoid ligaments"},"content":{"rendered":"<header class=\"entry-header\">\n<h1 class=\"entry-title\">Ankle testing. Ottowa Rules, The anterior drawer and talar tilt tests, syndesmosis and deltoid\u00a0ligaments.<\/h1>\n<\/header>\n<div class=\"entry-body\">\n<div class=\"entry-content\">\n<p>In the acute setting, ankle X-ray are indicated if there is bony tenderness according to the Ottawa Ankle Rules or if the patient is unable to bear weight both immediately following the injury and at the time of the subsequent clinical assessment. Followed correctly, the Ottawa Ankle Rules detect all clinically significant fractures (100% sensitivity).<\/p>\n<p><img decoding=\"async\" class=\"alignnone size-full wp-image-7106\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png?w=825\" sizes=\"(max-width: 825px) 100vw, 825px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png?w=825 825w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png?w=1650 1650w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png?w=150 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png?w=300 300w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png?w=768 768w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png?w=1024 1024w\" alt=\"Sk\u00e6rmbillede 2016-03-01 kl. 09.41.56\" data-attachment-id=\"7106\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/03\/01\/ottowa-rules\/skaermbillede-2016-03-01-kl-09-41-56\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png\" data-orig-size=\"1706,378\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-03-01 kl. 09.41.56\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-41-56.png?w=825\" \/><\/p>\n<div class=\"jetpack-video-wrapper\"><span class=\"embed-youtube\"><iframe class=\"youtube-player\" src=\"https:\/\/www.youtube.com\/embed\/_DSprZuA6HU?version=3&amp;rel=1&amp;showsearch=0&amp;showinfo=1&amp;iv_load_policy=1&amp;fs=1&amp;hl=en&amp;autohide=2&amp;wmode=transparent\" sandbox=\"allow-scripts allow-same-origin allow-popups allow-presentation\" allowfullscreen=\"allowfullscreen\" data-ratio=\"0.5636363636363636\" data-width=\"825\" data-height=\"465\" data-mce-fragment=\"1\"><\/iframe><\/span><\/div>\n<p>Other views of the ankle that can be useful include:<\/p>\n<ul>\n<li>Anterior or posterior impingement views. These are lateral views in plantarflexion (for posterior) or dorsiflexion (for anterior impingement) that help determine the degree to which bony factors contribute to ankle impingement.<\/li>\n<li>Weight-bearing views. These help in assessing articular cartilage loss, subluxation at the ankle joint, and diastasis (widening) of the distal tibiofibular syndesmosis.<\/li>\n<li>Lazy lateral view. The lateral malleolus is projected behind the medial malleolus. The lateral tubercle of the posterior process of the talus, or os trigonum is profiled.<\/li>\n<li>AP view of the proximal fibula. This view should be used whenever a Maisonneuve fracture is suspected.<\/li>\n<li>Stress views with inversion, eversion and anterior drawer stress views may highlight ligamentous instability.<\/li>\n<\/ul>\n<div class=\"tiled-gallery type-rectangular\" data-original-width=\"825\" data-carousel-extra=\"{&quot;blog_id&quot;:49480562,&quot;permalink&quot;:&quot;https:\\\/\\\/physioblogandreasbjerregaard.com\\\/2016\\\/03\\\/01\\\/ottowa-rules\\\/&quot;,&quot;likes_blog_id&quot;:49480562}\">\n<div class=\"gallery-row\" data-original-width=\"825\" data-original-height=\"252\">\n<div class=\"gallery-group images-1\" data-original-width=\"418\" data-original-height=\"252\">\n<div class=\"tiled-gallery-item tiled-gallery-item-large\"><a href=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/03\/01\/ottowa-rules\/skaermbillede-2016-03-01-kl-09-42-52\/\"><img fetchpriority=\"high\" decoding=\"async\" title=\"Sk\u00e6rmbillede 2016-03-01 kl. 09.42.52\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-42-52.png?w=414&amp;h=248\" alt=\"Sk\u00e6rmbillede 2016-03-01 kl. 09.42.52\" width=\"414\" height=\"248\" data-attachment-id=\"7111\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-42-52.png\" data-orig-size=\"1376,824\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-03-01 kl. 09.42.52\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-42-52.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-42-52.png?w=825\" data-original-width=\"414\" data-original-height=\"248\" \/><\/a><\/div>\n<\/div>\n<div class=\"gallery-group images-1\" data-original-width=\"407\" data-original-height=\"252\">\n<div class=\"tiled-gallery-item tiled-gallery-item-large\"><a href=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/03\/01\/ottowa-rules\/skaermbillede-2016-03-01-kl-09-43-01\/\"><img decoding=\"async\" title=\"Sk\u00e6rmbillede 2016-03-01 kl. 09.43.01\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-43-01.png?w=403&amp;h=248\" alt=\"Sk\u00e6rmbillede 2016-03-01 kl. 09.43.01\" width=\"403\" height=\"248\" data-attachment-id=\"7110\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-43-01.png\" data-orig-size=\"1318,812\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-03-01 kl. 09.43.01\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-43-01.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/03\/skc3a6rmbillede-2016-03-01-kl-09-43-01.png?w=825\" data-original-width=\"403\" data-original-height=\"248\" \/><\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"jetpack-video-wrapper\"><span class=\"embed-youtube\"><iframe class=\"youtube-player\" src=\"https:\/\/www.youtube.com\/embed\/AFoPJH567sE?version=3&amp;rel=1&amp;showsearch=0&amp;showinfo=1&amp;iv_load_policy=1&amp;fs=1&amp;hl=en&amp;autohide=2&amp;wmode=transparent\" sandbox=\"allow-scripts allow-same-origin allow-popups allow-presentation\" allowfullscreen=\"allowfullscreen\" data-ratio=\"0.5636363636363636\" data-width=\"825\" data-height=\"465\" data-mce-fragment=\"1\"><\/iframe><\/span><\/div>\n<div class=\"jetpack-video-wrapper\"><span class=\"embed-youtube\"><iframe class=\"youtube-player\" src=\"https:\/\/www.youtube.com\/embed\/ZCSz7_MO8nI?version=3&amp;rel=1&amp;showsearch=0&amp;showinfo=1&amp;iv_load_policy=1&amp;fs=1&amp;hl=en&amp;autohide=2&amp;wmode=transparent\" sandbox=\"allow-scripts allow-same-origin allow-popups allow-presentation\" allowfullscreen=\"allowfullscreen\" data-ratio=\"0.5636363636363636\" data-width=\"825\" data-height=\"465\" data-mce-fragment=\"1\"><\/iframe><\/span><\/div>\n<p><a href=\"http:\/\/f-marc.com\/footballdiploma\/lessons\/ankle-impingement\/\" rel=\"nofollow\">http:\/\/f-marc.com\/footballdiploma\/lessons\/ankle-impingement\/<\/a><\/p>\n<div class=\"jetpack-video-wrapper\"><span class=\"embed-youtube\"><iframe class=\"youtube-player\" src=\"https:\/\/www.youtube.com\/embed\/7TJoPw5sH2c?version=3&amp;rel=1&amp;showsearch=0&amp;showinfo=1&amp;iv_load_policy=1&amp;fs=1&amp;hl=en&amp;autohide=2&amp;wmode=transparent\" sandbox=\"allow-scripts allow-same-origin allow-popups allow-presentation\" allowfullscreen=\"allowfullscreen\" data-ratio=\"0.5636363636363636\" data-width=\"825\" data-height=\"465\" data-mce-fragment=\"1\"><\/iframe><\/span><\/div>\n<div id=\"jp-post-flair\" class=\"sharedaddy sd-like-enabled sd-sharing-enabled\">\n<div class=\"sharedaddy sd-sharing-enabled\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Ankle testing. Ottowa Rules, The anterior drawer and talar tilt tests, syndesmosis and deltoid\u00a0ligaments. In the acute setting, ankle X-ray are indicated if there is bony tenderness according to the Ottawa Ankle Rules or if the patient is unable to bear weight both immediately following the injury and at the time of the subsequent clinical assessment. Followed correctly, the Ottawa Ankle Rules detect all clinically significant fractures (100% sensitivity). Other views of the ankle that can be useful include: Anterior or posterior impingement views. These are lateral views in plantarflexion (for posterior) or dorsiflexion (for anterior impingement) that help determine the degree to which bony factors contribute to ankle impingement. Weight-bearing views. These help in assessing articular cartilage loss, subluxation at the ankle joint, and diastasis (widening) of the distal tibiofibular syndesmosis. Lazy lateral view. The lateral malleolus is projected behind the medial malleolus. The lateral tubercle of the posterior process of the talus, or os trigonum is profiled. AP view of the proximal fibula. This view should be used whenever a Maisonneuve fracture is suspected. Stress views with inversion, eversion and anterior drawer stress views may highlight ligamentous instability. <a href=\"http:\/\/f-marc.com\/footballdiploma\/lessons\/ankle-impingement\/\" rel=\"nofollow\">http:\/\/f-marc.com\/footballdiploma\/lessons\/ankle-impingement\/<\/a><\/p>\n","protected":false},"author":1,"featured_media":1850,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"postBodyCss":"","postBodyMargin":[],"postBodyPadding":[],"postBodyBackground":{"backgroundType":"classic","gradient":""},"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_hide_featured_image":false,"_jetpack_featured_image_duplicate_dismissed":0,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[227,2],"tags":[17,290,291,292],"class_list":["post-1848","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ankel-sprains","category-ankle-injuries","tag-ankle","tag-bone","tag-fracture","tag-ottowarules"],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":7}},"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.5 - aioseo.com -->\n\t<meta name=\"description\" content=\"Ankle testing. Ottowa Rules, The anterior drawer and talar tilt tests, syndesmosis and deltoid ligaments. In the acute setting, ankle X-ray are indicated if there is bony tenderness according to the Ottawa Ankle Rules or if the patient is unable to bear weight both immediately following the injury and at the time of the subsequent clinical\" \/>\n\t<meta name=\"robots\" content=\"max-image-preview:large\" \/>\n\t<meta name=\"author\" content=\"Andreas Bjerregaard\"\/>\n\t<link rel=\"canonical\" href=\"https:\/\/andreasphysioblog.com\/?p=1848\" \/>\n\t\t<meta name=\"generator\" content=\"All in One SEO (AIOSEO) 5.0.5\" \/>\n\t\t<meta property=\"og:locale\" content=\"en_US\" \/>\n\t\t<meta property=\"og:site_name\" content=\"Physioblog by Andreas Bjerregaard -\" \/>\n\t\t<meta property=\"og:type\" content=\"article\" \/>\n\t\t<meta property=\"og:title\" content=\"Ankle testing. 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