According to the Ottawa ankle rules, radiographs are not indicated when which condition is present?

• A. No tenderness and the patient can bear weight.
• B. Tenderness at the malleolar region.
• C. Inability to bear weight.
• D. Swelling.

Answer: (A)

The key idea is that Ottawa ankle rules use specific clinical signs to decide when imaging is needed. If there is no bone tenderness in the malleolar zone and the patient is able to bear weight both immediately and in the emergency department (typically four steps), the chance of a fracture is very low, so radiographs are not indicated. This is exactly the scenario described by no tenderness and the ability to bear weight.

Tenderness in the malleolar region or the inability to bear weight are the findings that push toward getting X-rays, because they raise suspicion for a fracture. Swelling by itself isn’t a definitive trigger for imaging under these rules.