An acute injury to the ankle or knee is usually caused by a single incident – for example, a twist, fall, excessive force or direct blow from a solid object – and results in a rapid onset of symptoms, usually within 48 hours.
In the decade to 2012, about 25% of the sprains/strains managed by Australian GPs (excluding those of the back) were related to the ankle or knee.
There is good evidence that history and physical examination by an experienced examiner can be as accurate as imaging for diagnosis of uncomplicated acute ankle and knee injuries. Most ankle sprains and many knee sprains respond well to simple treatments (eg, RICE) and other measures such as wearing a brace and/or physiotherapy.
Unless surgery is being considered, referral or request for imaging by a primary care provider may only add to cost and time without changing management at all.
Guidelines and publications
RANZCR Choosing Wisely Australia recommendations and clinical decision rules booklet
This booklet elaborates on each Royal Australian and New Zealand College of Radiologists Choosing Wiely Australia recommendation and its Clinical Decision Rules. Download the RANZCR Choosing Wisely Australia recommendations and clinical decision rules booklet.
Continuing professional development (CPD)
Consolidate your knowledge about ankle and knee injuries and your imaging choices, brush up on current guidelines and practices and earn CPD points through free NPS MedicineWise learning activities.
Online case study
Diagnostic imaging in acute ankle and knee injuries
In this free online case study you will meet two patients – Brian, a 48-year old self-employed painter who has injured his knee when stepping down from a ladder, and Liz, a 28-year old accountant who has injured her ankle at netball.
Clinical information
Quality use of medical imaging means choosing the right imaging option for the patient and using it at the right time. We have compiled some of the latest evidence and guidelines on imaging for acute ankle and knee injuries to support discussions with your patients.
Medicinewise News October 2016
This article covers the latest evidence on acute knee pain presentations in middle-aged patients, and the role of MRI in diagnosis.
Physical examination videos
Watch Dr Michael Ellis conduct clinical tests for assessing ligament or joint damage at the ankle and knee.
Tools, calculators and apps
RANZCR Appropriate Use of Medical Imaging Android App
The RANZCR Appropriate Use of Medical Imaging Android App features high performing, well validated clinical decision rules to help doctors undertake evidence based risk assessment of patients to determine if imaging is required in patient with a range of common conditions. Find the RANZCR Appropriate Use of Medical Imaging App on the GooglePlay Store.
RANZCR Appropriate Use of Medical Imaging iTunes App
The RANZCR Appropriate Use of Medical Imaging App features high performing, well validated clinical decision rules to help doctors undertake evidence based risk assessment of patients to determine if imaging is required in patient with a range of common conditions. Find the RANZCR Appropriate Use of Medical Imaging App on iTunes.
5 Questions
5 questions to ask your doctor or other healthcare provider to make sure you end up with the right amount of care.