![]() Bone stress injuries (BSI) are the inability of a bone to withstand repetitive loading. Not all bone injuries are displaced fractures. A positive test is reproduction of pain along the shaft of the 5th metatarsal. The clinician grasps the metatarsal distal aspect of the 5th metatarsal and applies a longitudinal load. The metatarsal load test is used to evaluate the potential of this injury. This injury is known as a Jones fracture. Metatarsal Load TestĪnother bone commonly fractured is the 5 th metatarsal. Fortunately, radiographs have a specificity of 88% – making them a strong diagnostic tool. The high sensitivity tells us they are designed be a reliable screening tool to determine if a radiograph is needed. These data are displayed below:Īs per the statistical data, one can see from the low specificity, the Ottawa Rules are not intended to be diagnostic of a fracture. They have been validated for both adults and children. Both of these sets of rules have been studied extensively. Interpretation is if ANY of the criteria are positive, a radiographic series is warranted. Further studies fine-tuned these “rules” to become the Ottawa Ankle and Ottawa Foot Rules. Equally impressive is the fact that using these “rules” would allow for a reduction of 36% of radiographs ordered. Using these rules, the sensitivity was 100% and specificity was 40%. What they found was that all 70 malleolar fracture identified in 689 ankle radiographs identified pain near the malleoli, were over 55 years of age, had local tenderness on the posterior edge or tip of the malleoli, or were unable to bear weight immediately/in the emergency room. ![]() They identified the clinical variables capable of predicting fractures and/or the need for radiographs. In 1992, Stiell et al conducted a pilot with 155 adults and a main study with 750 adults. However, there are clinical tests that can help you determine if a radiograph is really necessary. ![]() Unless you have x-ray eyes, you don’t have that immediate answer. That is often the first question asked about an ankle injury. News Orthopedic Clinical Tests iOrtho Admin JanuIs it broken? ![]()
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