title: The relevance of hearing a crack in ankle injuries.
abstract: OBJECTIVE
  To examine the predictive value of a crack noise or sensation in the history of injury in the diagnosis of ankle fracture.
  
  
  METHODS
  A short questionnaire was filled in on 464 patients with isolated ankle injuries attending the accident and emergency department in a three month period from July to September. These patients were seen in the usual way in the department and the need for x ray assessed according to clinical judgement and existing departmental guidelines. Cases which subsequently proved to be other than ankle injuries, for example, fractured calcaneus, were excluded from the study.
  
  
  RESULTS
  A positive history of hearing or feeling a crack did not indicate the need for an x ray or increase the possibility of a fracture; indeed the history of a crack made the presence of a fracture less likely. The clinical diagnosis of absence of fracture without radiological examination may require careful explanation to the patient.
  
  
  CONCLUSIONS
  Hearing a crack in the ankle does not suggest a fracture.
authors.affiliation: Department of Accident and Emergency Medicine, Addenbrooke's Hospital, Cambridge.
authors.forename: P M
authors.initials: PM
authors.lastname: Reid
authors.forename: A K
authors.initials: AK
authors.lastname: Aggarwal
authors.forename: C
authors.initials: C
authors.lastname: Browning
authors.forename: P
authors.initials: P
authors.lastname: Nicolai
mesh_terms: D016512:Ankle Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005596:Fractures, Closed / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D009622:Noise; D011859:Radiography