ObjectiveTo assess the potential impact of the Shetty test over Ottawa ankle foot rules (OAFR) on plain imaging utilisation in the ED.MethodsNursing and medical staff assessed both Shetty test and OAFR in ED. All patients received ankle and foot radiographs.ResultsFifty‐four participants were assessed. Shetty test specificity at triage was 0.40 (95% CI 0.25–0.57), compared to OAFR 0.10 (95% CI 0.03–0.24), McNemar's P < 0.01. Shetty test and OAFR sensitivity at triage was 0.92 (95% CI 0.64–0.99), McNemar's P = 1.00.ConclusionShetty test may safely reduce unneeded radiographs in ED. Further research is warranted.