Goodsall's Rule states that 
Fistulas can be described as anterior or posterior relating to a line drawn in the coronal plane across the anus, the so-called transverse anal line. Anterior fistulas will have a direct track into the anal canal. Posterior fistulas will have a curved track with their internal opening lying in the posterior midline of the anal canal. An exception to the rule is anterior fistulas lying more than 3 cm. from the anus, which may open in the anterior midline of the anal canal.
Successful treatment of an anal fistula requires correct identification of the internal opening and accurate delineation of the course of the fistula in relation to the anal sphincters. 
Goodsall’s rule is of limited use in predicting the site of the internal opening of a fistula. The closer the external opening is to the anal verge, the more likely a fistula conforms to the rule. The further a fistula is away from the anal verge, the more likely it follows a horseshoe course and less likely to conform to Goodsall’s rule.
Predictive accuracy of Goodsall’s rule found to be 84.6% in case of fistula with an anterior external opening. While in case of fistula with posterior external opening this found to be 69.1%. Overall predictive accuracy of Goodsall’s rule is 77%. 

Satyendra Dhar MD, @DharSaty

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Satyendra Dhar, MD @DharSaty · 3 years ago
Hospital Medicine Clinical Assistant Professor The content and images on this website are provided for educational and informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. The views expressed are those of the authors and do not necessarily reflect those of any affiliated institutions. While efforts are made to ensure accuracy and currency, medical knowledge is continually evolving, and errors or omissions may occur. Users are advised to independently verify information and seek guidance from qualified healthcare professionals for any medical decisions. By using this website, you acknowledge responsibility for your own clinical judgments, and the website and its contributors disclaim any liability arising from the use of its content. 👉 Follow 'Medical Infographics' on 👉 https://www.DharSaty.com
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