The Guidelines and Protocols Advisory Committee (GPAC) has revised its guideline Ankle Injury—X-ray for Acute Injury of the Ankle or Mid-Foot (2014). The revised guideline is available online at www.bcguidelines.ca/guideline_anklex.html [9].

This guideline makes recommendations for adults who are 19 years or older with acute ankle and mid-foot injuries, presenting for the first time in a clinical setting (emergency department and primary care). The guideline excludes recommendations for patients who are younger than 19 years, have multiple painful injuries, or those who are pregnant, cognitively impaired, or with sensory deficits in their lower extremities.

Key recommendations:
•    Use the Ottawa Ankle Rules to exclude fractures and reduce unnecessary imaging.
•    Advise patients to seek follow-up care if their pain or ability to bear weight has not improved in 5 to 7 days. 

For the complete list of GPAC guidelines, visit www.bcguidelines.ca [10]. Physicians interested in participating in the development of future guidelines and protocols are encouraged to e-mail GPAC at hlth.guidelines@gov.bc.ca [11]. Physician participation in guidelines and protocols development is compensated at the Doctors of BC sessional rate.