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Ottawa Foot, Ankle and Knee rules – Mnemonic

Ottawa Ankle and Foot Rules

Mnemonic: 44-55-66-PM

Patients need an X-ray only if:

4: Unable to do 4 steps immediately AND
4: Unable to do 4 steps at Emergency Department

OR

5: Has pain at the base of 5th metatarsal
5: Has pain at the 5caphoid (Navicular)

OR

6: Tenderness in 6 cm tip or Posterior edge of lateral Malleolus
6: Tenderness in 6 cm tip or Posterior edge of medial Malleolus

Ottawa Knee Rules

Mnemonic: WAIT

WAIT, get an X-ray of knee if:

  1. Weight bearing for 4 steps not possible – immediately and in ER
  2. Age ≥55 years
  3. Inability to flex knee to 90 degrees
  4. Tenderness isolated to patella or head of fibula
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