When a Twisted Ankle Needs an X-Ray

Knowing when to get an X-ray for a sprained ankle can prevent long-term complications.

Apr. 6, 2026 at 9:54pm

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A translucent, ghostly X-ray image revealing the internal bone and ligament structures of a human ankle joint, conceptually illustrating the importance of getting an X-ray to properly diagnose a twisted ankle injury.An X-ray examination can help determine if a twisted ankle is a sprain or a fracture, ensuring proper treatment and preventing long-term complications.Idaho Falls Today

Most twisted ankles don't require an X-ray, but some do - and waiting too long to find out can lead to a longer, more complicated recovery. Fractures need different treatment than sprains, and if not treated correctly, can cause chronic pain, instability, and arthritis later on. Doctors recommend getting an X-ray the same day if there is severe pain, rapid swelling, deformity, or trouble walking, as these could be signs of a fracture rather than just a sprain.

Why it matters

Knowing when to get an X-ray for a twisted or sprained ankle is important because a fracture requires different treatment than a sprain. If a fracture isn't treated properly, it can lead to long-term issues like chronic pain, instability, and arthritis. Getting checked out right away can help ensure the injury is properly diagnosed and treated.

The details

A sprain is a stretched or torn ligament, while a fracture is a broken bone. Early on, they can feel similar, but fractures need different treatment. Some fractures are small and stable, while others may shift out of place or involve the joint, requiring a boot, cast, or surgery. If a fracture isn't treated correctly, the bone can heal in the wrong position, leading to long-term problems.

  • If you heard or felt a pop at the time of injury, you should get checked the same day.
  • If you can't take four steps on the foot, even while limping, you should get checked the same day.
  • If the pain is severe and not improving with rest and ice, you should get checked the same day.
  • If the swelling is rapid and significant, especially within the first hour, you should get checked the same day.
  • If the ankle looks deformed, out of alignment, or 'pointing the wrong way', you should get checked the same day.

The players

Mountain View Hospital

A hospital located in Idaho that provides medical care, including treatment for ankle injuries.

Idaho Falls Community Hospital

A hospital located in Idaho that provides medical care, including treatment for ankle injuries.

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What’s next

If the ankle is not improving after a few days, if it keeps giving out, or if pain is lingering in one spot, see a clinician. You may need physical therapy or imaging to rule out other injuries.

The takeaway

Getting an X-ray as soon as possible after a twisted ankle, especially if there are signs of a potential fracture, can help ensure the injury is properly diagnosed and treated. This can prevent long-term complications like chronic pain, instability, and arthritis.