Research
Effect of the Low Risk Ankle Rule on the frequency of radiography in children with ankle injuries
Kathy Boutis, Paul Grootendorst, Andrew Willan, Amy C. Plint, Paul Babyn, Robert J. Brison, Arun Sayal, Melissa Parker, Natalie Mamen, Suzanne Schuh, Jeremy Grimshaw, David Johnson and Unni Narayanan
CMAJ October 15, 2013 185 (15) E731-E738; DOI: https://doi.org/10.1503/cmaj.122050
Kathy Boutis
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MD MScPaul Grootendorst
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
PhDAndrew Willan
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
PhDAmy C. Plint
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MDPaul Babyn
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MDRobert J. Brison
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MDArun Sayal
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MDMelissa Parker
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MD MScNatalie Mamen
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MDSuzanne Schuh
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MDJeremy Grimshaw
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MB BChDavid Johnson
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MDUnni Narayanan
Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
MD MScArticle Information
vol. 185 no. 15 E731-E738
PubMed
History
- Published online October 15, 2013.
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- Latest version (August 12, 2013 - 08:32).
- Latest version (August 19, 2013 - 09:08).
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© 2013 Canadian Medical Association or its licensors
Author Information
- Kathy Boutis, MD MSc⇑,
- Paul Grootendorst, PhD,
- Andrew Willan, PhD,
- Amy C. Plint, MD,
- Paul Babyn, MD,
- Robert J. Brison, MD,
- Arun Sayal, MD,
- Melissa Parker, MD MSc,
- Natalie Mamen, MD,
- Suzanne Schuh, MD,
- Jeremy Grimshaw, MB BCh,
- David Johnson, MD,
- Unni Narayanan, MD MSc
- Division of Emergency Medicine (Boutis, Parker, Schuh), Department of Pediatrics, Hospital for Sick Children, University of Toronto; Faculty of Pharmacy (Grootendorst), University of Toronto, Toronto, Ont.; Department of Economics (Grootendorst), McMaster University, Hamilton, Ont.; Hospital for Sick Children Research Institute (Willan), University of Toronto, and Dalla Lana School of Public Health, Toronto, Ont.; Division of Emergency Medicine (Plint), Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ont.; Department of Radiology (Babyn), University of Saskatchewan, Saskatoon, Sask.; Department of Emergency Medicine (Brison), Kingston General Hospital, Kingston, Ont.; Department of Emergency Medicine (Sayal), North York General Hospital, Toronto, Ont.; Divisions of Critical Care and Emergency Medicine (Parker), Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ont.; Department of Emergency Medicine (Mamen), Toronto East General Hospital, East York, Ont.; Clinical Epidemiology Program (Grimshaw), Ottawa Health Research Institute, Ottawa Ont.; Division of Emergency Medicine (Johnson), Department of Pediatrics, Alberta Children’s Hospital, Calgary Alta.; Department of Orthopedics (Narayanan), Hospital for Sick Children, Toronto, Ont.
- Correspondence to: Kathy Boutis, kleanthi.boutis{at}sickkids.ca
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Effect of the Low Risk Ankle Rule on the frequency of radiography in children with ankle injuries
Kathy Boutis, Paul Grootendorst, Andrew Willan, Amy C. Plint, Paul Babyn, Robert J. Brison, Arun Sayal, Melissa Parker, Natalie Mamen, Suzanne Schuh, Jeremy Grimshaw, David Johnson, Unni Narayanan
CMAJ Oct 2013, 185 (15) E731-E738; DOI: 10.1503/cmaj.122050
Effect of the Low Risk Ankle Rule on the frequency of radiography in children with ankle injuries
Kathy Boutis, Paul Grootendorst, Andrew Willan, Amy C. Plint, Paul Babyn, Robert J. Brison, Arun Sayal, Melissa Parker, Natalie Mamen, Suzanne Schuh, Jeremy Grimshaw, David Johnson, Unni Narayanan
CMAJ Oct 2013, 185 (15) E731-E738; DOI: 10.1503/cmaj.122050
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