Why MRI in Ankle?
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Welcome to MRI Online. MRI of the ankle,
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foot, and ankle, and eventually we'll
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work our way down to the great toe.
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They used to say, why MRI of the ankle?
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An ankle sprain, just a sprain,
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it's a clinical diagnosis, right?
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Well, not so much.
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They also used to say that MRI
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of the skeleton wasn't very good.
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Well, that's not true.
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Not so much.
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MRI of a skeleton shows innumerable fractures,
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intramedullary, that you can almost never
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see on conventional radiography, that actually
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tell you what the mechanism of injury is
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and lead you to the correct diagnosis.
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And sometimes, even macro fractures show
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up on MRI, and the plain films are often
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negative with only soft tissue swelling.
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So let's get back to some of the
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Strengths and the whys of why we do MRI.
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The soft tissues are the strength of MRI.
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And perhaps in no other joint are the soft
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tissues so critical in injuries as they are in
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the ankle, where the ligaments, the anterior
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talofibular ligament, and some of the other
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lesser injured ligaments are critical to evaluate.
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Now you might say, okay, I can do that with
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a clinical physical examination, so what?
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But there are other things that
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go along with ankle sprains.
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Like osteochondral defects, fibular
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gutter syndrome, meniscoid lesions, all
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of which you're going to learn about.
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And these affect what the
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treatment is going to be.
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But there's, there's oh so much more.
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There's a lot of soft tissues about the ankle.
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There are tendons, medial, lateral,
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extensor, dorsal, posterior.
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Assessment of the Achilles for
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whether you operate or don't operate.
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Often depends on the MR findings.
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And that's also true for almost
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all the other tendons of the ankle.
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The plantar fascia, a very nagging area
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Of interest, very problematic clinically.
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We can tell whether we have mild, moderate,
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Severe plantar fasciitis, periostitis,
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Accompanying stress fracture, and a transection
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Of the plantar fascia which affects treatment.
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There are certain masses about the foot and ankle
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That have very characteristic appearances that
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Allow you to slam the door on the diagnosis, one
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Of which would be plantar fibromatosis, which is
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Basically Dupuytren's contracture of the foot.
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The decision as to whether to resect or
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Leave alone, often based on purely MRI.
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The decision as to whether to
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Go after a Morton's neuroma,
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Which is basically an entrapment neuropathy of
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The digital nerve between the metatarsals is
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Often based on both the clinical and the MR.
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These are just a few examples of why MR
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Has become the leading imaging modality
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For examination of the ankle, the foot,
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The midfoot, the toes, and the great toe.
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Let's get started, shall we?
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
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