| Leiden ankle rules | Utrecht ankle rules | ||
| Deformity/instability/crepitating | 5 | Deformity/instability/crepitating | 4 |
| Weight bearing* | 3 | Weight bearing/axial compression* | 2 |
| Pulseless/weak posterior tibial artery† | 2 | Pain on palpation/swelling | |
| Pain and palpation malleoli/metatarsal V‡ | 2 | Pain on palpation/swelling | |
| Swelling malleoli/metatarsal V | 2 | Tibia | 1 |
| Swelling/pain in Achilles tendon | 1 | Fibula | 1 |
| Age divided by 10 | Achilles tendon | 1 | |
| Radiographs required if | >7 | Base of fifth metatarsal | 1 |
| Sensitivity 88%; specificity 57% | Haematoma/haemarthrosis | 1 | |
| Age divided by 10 | |||
| Radiographs required if | ≥8 | ||
| Sensitivity 59%; specificity 84% |
*Inability to bear weight was defined as the inability to walk four steps. Axial compression pain was defined as pain on application of axial compression.
†Positive in case of a marked difference with the contralateral side.
‡Of the posterior edge (6 cm) of both the lateral and the inability to walk four steps. Axial and medial malleolus and the base of the fifth metatarsal bone.
NPV, negative predictive value; PPV, positive predictive value.