Provided that there are no fractures of the tibial or fibular shafts, if ankle pain can be elicited by this squeeze maneuver, one should suspect an injury to one or more of the components of the tibiofibular syndesmosis.

Questions:

It is estimated that over $500 million dollars are spent each year on ankle radiographs. However the majority (up to 85%) of these radiographs are negative. In 1992, a Canadian study suggested the adaptation of the Ottawa ankle rules, which could be used to order ankle radiographs based on selected clinical criteria. It is important to remember that this study excluded patients younger than 18 years of age. Therefore, since the Ottawa study did not include growth plate injuries, one should not strictly adhere to these rules when deciding whether or not to obtain a radiograph on a pediatric patient. Based on these Ottawa ankle rules, clinical indications that would warrant a radiographic evaluation would include any one of the following criteria:

A complete, standard radiograph examination of the ankle should include 3 views (AP, lateral, and a mortise view).