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MRI of the Ankle: Detailed Anatomy

This webpage presents the anatomical structures found on ankle MRI.

MRI of ankle, sagittal view, image 1.1, Tibia (medial malleolus). 2, Navicular. 3, Tibialis anterior tendon. 4, Medial cuneiform. 5, 1st metatarsal. 6, Flexor hallucis brevis muscle. 7, Abductor hallucis muscle. 8, Tibialis posterior tendon.
  • MRI of ankle, sagittal view, image 1.1, Tibia (medial malleolus). 2, Navicular. 3, Tibialis anterior tendon. 4, Medial cuneiform. 5, 1st metatarsal. 6, Flexor hallucis brevis muscle. 7, Abductor hallucis muscle. 8, Tibialis posterior tendon.

  • MRI of the ankle, sagittal view, T1. Image 2. 1, Tibia (Medial malleolus). 2, Navicular. 3, Tibialis anterior tendon. 4, Medial cuneiform. 5, 1st metatarsal. 6, Flexor hallucis brevis muscle. 7, Abductor hallucis muscle.

  • MRI of the ankle, sagittal view, T1. Image 3. 1, Tibia (Medial malleolus). 2, Talus. 3, Tibialis anterior tendon. 4, Navicular. 5, Medial cuneiform. 6, 1st metatarsal. 7, Flexor hallucis brevis muscle. 8, Abductor hallucis muscle.

  • MRI of the ankle, sagittal view, T1. Image 4. 1, Tibia (Medial malleolus). 2, Talus. 3, Tibialis anterior tendon. 4, Navicular. 5, Medial cuneiform. 6, 1st metatarsal.

  • MRI of the ankle, sagittal view, T1. Image 5. 1, Tibia. 2, Talus. 3, Tibialis anterior tendon. 4, Navicular. 5, Medial cuneiform. 6, Flexor digitorum brevis muscle. 7, Flexor hallucis longus tendon & Flexor digitorum longus tendon.

  • MRI of the ankle, sagittal view, T1. Image 6. 1, Tibia. 2, Tibialis anterior tendon. 3, Navicular. 4, Intermediate cuneiform. 5, Flexor digitorum brevis muscle. 6, Calcaneus. 7, Talus.

  • MRI of the ankle, sagittal view, T1. Image 7. 1, Tibia. 2, Tibialis anterior tendon. 3, Talus. 4, Navicular. 5, Intermediate cuneiform. 6, 2nd metatarsal. 7, Flexor digitorum brevis muscle. 8, Plantar aponeurosis. 9, Quadratus plantae muscle . 10, Calcaneus. 11, Flexor hallucis longus tendon. 12, Flexor digitorum longus tendon.

  • MRI of the ankle, sagittal view, T1. Image 8. 1, Tibia. 2, Tendon & muscle Tibialis anterior / Extensor hallucis longus . 3, Talus. 4, Navicular. 5, Intermediate cuneiform. 6, 2nd metatarsal. 7, Plantar aponeurosis. 8, Calcaneus. 9, Achilles tendon. 10, Flexor hallucis longus tendon & muscle. 11, Soleus muscle.

  • MRI of the ankle, sagittal view, T1. Image 9. 1, Tibia. 2, Tendon & muscle Tibialis anterior / Extensor hallucis longus. 3, Talus. 4, Sinus Tarsi. 5, Navicular. 6, Intermediate cuneiform. 7, 2nd metatarsal. 8, 3rd metatarsal. 9, Adductor hallucis muscle. 10, Peroneus longus tendon. 11, Plantar aponeurosis. 12, Calcaneus. 13, Achilles tendon. 14, Flexor hallucis longus tendon & muscle. 15, Soleus muscle.

  • MRI of the ankle, sagittal view, T1. Image 10. 1, Tibia. 2, Tendon & muscle Tibialis anterior / Extensor hallucis longus . 3, Talus. 4, Lateral cuneiform. 5, 3rd metatarsal. 6, Flexor digitorum brevis muscle. 7, Peroneus longus tendon. 8, Calcaneus. 9, Achilles tendon. 10, Flexor hallucis longus tendon & muscle. 11, Soleus muscle.

  • MRI of the ankle, sagittal view, T1. Image 11.1, Tibia. 2, Talus 3, Lateral cuneiform. 4, 3rd and 4th metatarsals. 5, Calcaneus. 6, Achilles tendon. 7, Flexor hallucis longus tendon & muscle. 8, Soleus muscle.

  • MRI of the ankle, sagittal view, T1. Image 12. 1, Tibia. 2, Talus. 3, Cuboid. 4, Lateral cuneiform. 5, 3rd metatarsal. 6, 4th metatarsal. 7, Abductor digiti minimi muscle. 8, Calcaneus. 9, Achilles tendon. 10, Flexor hallucis longus tendon & muscle. 11, Soleus muscle.

  • MRI of the ankle, sagittal view, T1. Image 13. 1, Extensor digitorum longus muscle. 2, Tibia. 3, Cuboid. 4, 4th metatarsal. 5, Abductor digiti minimi muscle. 6, Calcaneus. 7, Achilles tendon. 8, Talus.

  • MRI of the ankle, sagittal view, T1. Image 14. 1, Extensor digitorum longus muscle. 2, Tibia. 3, Cuboid. 4, 4th metatarsal. 5, Flexor digitorum brevis muscle. 6, Peroneus longus tendon. 7, Abductor digiti minimi muscle. 8, Calcaneus. 9, Fibula. 10, Peroneus longus muscle.

  • MRI of the ankle, sagittal view, T1. Image 15. 1, Extensor digitorum longus muscle. 2, Fibula. 3, 5th metatarsal. 4, 4th metatarsal. 5, Abductor digiti minimi muscle. 6, Peroneus longus muscle.

  • MRI of the ankle, sagittal view, T1. Image 16. 1, Extensor digitorum longus muscle. 2, Fibula. 3, Peroneus longus tendon. 4, Peroneus brevis tendon. 5, 5th metatarsal. 6, Abductor digiti minimi muscle. 7, Peroneus longus muscle.

  • MRI of the ankle, sagittal view, T1. Image 17. 1, Extensor digitorum longus muscle. 2, Fibula. 3, Peroneus longus tendon. 4, 5th metatarsal. 5, Peroneus brevis muscle.

  • MRI of the ankle, sagittal view, T1. Image 18. 1, Fibula (lateral malleolus). 2, Peroneus longus tendon. 3, Peroneus brevis muscle.

  • MRI of ankle, axial view, image 1.1, Tibialis anterior tendon. 2, Extensor hallucis longus tendon. 3, Extensor digitorum longus tendon. 4, Fibula. 5, Peroneus longus tendon. 6, Peroneus brevis muscle. 7, Achilles tendon. 8, Flexor hallucis longus muscle. 9, Flexor digitorum longus muscle. 10, Tibialis posterior tendon.

  • MRI of ankle, axial view, image 2.1, Tibialis anterior tendon. 2, Extensor hallucis longus tendon. 3, Extensor digitorum longus tendon. 4, Fibula. 5, Peroneus longus tendon. 6, Peroneus brevis muscle. 7, Achilles tendon. 8, Flexor hallucis longus muscle. 9, Flexor digitorum longus tendon. 10, Tibialis posterior tendon.

  • MRI of ankle, axial view, image 3.1, Tibialis anterior tendon. 2, Extensor hallucis longus tendon. 3, Extensor digitorum longus tendon. 4, Fibula. 5, Peroneus longus tendon. 6, Peroneus brevis muscle. 7, Achilles tendon. 8, Flexor hallucis longus tendon. 9, Flexor digitorum longus tendon. 10, Tibialis posterior tendon. 11, Tibia (medial malleolus).

  • MRI of ankle, axial view, image 4.1, Tibialis anterior tendon. 2, Extensor hallucis longus tendon. 3, Extensor digitorum longus tendon. 4, Fibula. 5, Peroneus longus tendon. 6, Peroneus brevis muscle. 7, Achilles tendon. 8, Flexor hallucis longus tendon. 9, Talus. 10, Flexor digitorum longus tendon. 11, Tibialis posterior tendon. 12, Tibia (medial malleolus).

  • MRI of ankle, axial view, image 5.1, Tibialis anterior tendon. 2, Extensor hallucis longus tendon. 3, Extensor digitorum longus tendon. 4, Fibula. 5, Peroneus longus tendon. 6, Peroneus brevis muscle. 7, Achilles tendon. 8, Flexor hallucis longus tendon. 9, Talus. 10, Flexor digitorum longus tendon. 11, Tibialis posterior tendon. 12, Tibia (medial malleolus).

  • MRI of ankle, axial view, image 6.1, Tibialis anterior tendon. 2, Extensor hallucis longus tendon. 3, Extensor digitorum longus tendon. 4, Fibula. 5, Peroneus longus tendon. 6, Peroneus brevis muscle. 7, Achilles tendon. 8, Flexor hallucis longus tendon. 9, Flexor digitorum longus tendon. 10, Tibialis posterior tendon. 11, Talus.

  • MRI of ankle, axial view, image 7.1, Tibialis anterior tendon. 2, Extensor hallucis longus tendon. 3, Extensor digitorum longus tendon. 4, Fibula. 5, Peroneus longus tendon. 6, Peroneus brevis muscle. 7, Achilles tendon. 8, Flexor hallucis longus tendon. 9, Flexor digitorum longus tendon. 10, Tibialis posterior tendon. 11, Talus.

  • MRI of ankle, axial view, image 8.1, Tibialis anterior tendon. 2, Extensor hallucis longus tendon. 3, Extensor digitorum longus tendon. 4, Fibula. 5, Peroneus longus tendon. 6, Peroneus brevis muscle. 7, Achilles tendon. 8, Flexor hallucis longus tendon. 9, Flexor digitorum longus tendon. 10, Tibialis posterior tendon. 11, Talus.

  • MRI of ankle, axial view, image 9.1, Tibialis anterior tendon. 2, Navicular. 3, Extensor digitorum longus tendon. 4, Peroneus longus tendon. 5, Peroneus brevis muscle. 6, Achilles tendon. 7, Flexor hallucis longus tendon. 8, Flexor digitorum longus tendon. 9, Tibialis posterior tendon. 10, Talus.

  • MRI of ankle, axial view, image 10.1, Tibialis anterior tendon. 2, Medial cuneiform. 3, Intermediate cuneiform. 4, Navicular. 5, Extensor digitorum longus tendon. 6, Peroneus longus tendon. 7, Peroneus brevis muscle. 8, Achilles tendon. 9, Flexor hallucis longus tendon. 10, Flexor digitorum longus tendon. 11, Tibialis posterior tendon. 12, Talus.

  • MRI of ankle, axial view, image 11.1, Tibialis anterior tendon. 2, Medial cuneiform. 3, Intermediate cuneiform. 4, Navicular. 5, Extensor digitorum longus tendon. 6, Talus. 7, Peroneus longus tendon. 8, Calcaneus. 9, Achilles tendon. 10, Flexor hallucis longus tendon.

  • MRI of ankle, axial view, image 12.1, Tibialis anterior tendon. 2, Medial cuneiform. 3, Intermediate cuneiform. 4, Lateral cuneiform. 5, Extensor digitorum longus tendon. 6, Peroneus longus tendon. 7, Calcaneus. 8, Achilles tendon. 9, Talus. 10, Navicular.

  • MRI of ankle, axial view, image 13.1, Tibialis anterior tendon. 2, Medial cuneiform. 3, Intermediate cuneiform. 4, Lateral cuneiform. 5, Extensor digitorum longus tendon 6, Cuboid. 7, Peroneus longus tendon. 8, Calcaneus. 9, Achilles tendon. 10, Navicular.

  • MRI of ankle, axial view, image 14.1, Navicular. 2, Medial cuneiform. 3, Intermediate cuneiform. 4, Lateral cuneiform. 5, Extensor digitorum longus tendon. 6, Cuboid. 7, Peroneus longus tendon. 8, Calcaneus. 9, Achilles tendon.

  • MRI of ankle, axial view, image 15.1, Medial cuneiform. 2, 1st metatarsal. 3, Intermediate cuneiform. 4, Lateral cuneiform. 5, Extensor digitorum longus tendon. 6, Cuboid. 7, Peroneus longus tendon. 8, Calcaneus. 9, Achilles tendon. 10, Quadratus plantae muscle

  • MRI of ankle, axial view, image 16.1, Medial cuneiform. 2, 1st metatarsal. 3, Intermediate cuneiform. 4, Lateral cuneiform. 5, Extensor digitorum longus muscle & tendon. 6, Cuboid. 7, Calcaneus. 8, Achilles tendon. 9, Quadratus plantae muscle 10, Abductor hallucis muscle.

  • MRI of ankle, axial view, image 17.1, Medial cuneiform. 2, 1st metatarsal. 3, 2nd metatarsal. 4, Lateral cuneiform. 5, Extensor digitorum longus muscle & tendon. 6, Cuboid. 7, Calcaneus. 8, Achilles tendon. 9, Quadratus plantae muscle. 10, Abductor hallucis muscle.

  • MRI of ankle, axial view, image 18.1, Medial cuneiform. 2, 1st metatarsal. 3, Lateral cuneiform. 4, Cuboid. 5, Calcaneus. 6, Achilles tendon. 7, Quadratus plantae muscle. 8, Abductor hallucis muscle.

  • MRI of ankle, axial view, image 19.1, 1st metatarsal. 2, 2nd metatarsal. 3, 3rd metatarsal. 4, Cuboid. 5, Calcaneus. 6, Quadratus plantae muscle. 7, Abductor hallucis muscle.

  • MRI of ankle, axial view, image 20.1, 1st metatarsal. 2, 3rd metatarsal. 3, 4th metatarsal. 4, Cuboid. 5, Abductor digiti minimi muscle. 6, Calcaneus. 7, Abductor hallucis muscle. 8, Quadratus plantae muscle.

  • MRI of ankle, axial view, image 21.1, Abductor hallucis muscle. 2, 3rd metatarsal. 3, 4th metatarsal. 4, 5th metatarsal. 5, Abductor digiti minimi muscle. 6, Calcaneus. 7, Flexor digitorum brevis muscle.

  • MRI of ankle, axial view, image 22.1, Abductor hallucis muscle. 2, 4th metatarsal. 3, 5th metatarsal. 4, Abductor digiti minimi muscle. 5, Calcaneus. 6, Flexor digitorum brevis muscle.

  • MRI of ankle, axial view, image 23.1, Abductor hallucis muscle. 2, 5th metatarsal. 3, Abductor digiti minimi muscle. 4, Calcaneus. 5, Flexor digitorum brevis muscle.

  • MRI of ankle, axial view, image 24.1, Abductor hallucis muscle. 2, Flexor digitorum brevis muscle. 3, Abductor digiti minimi muscle. 4, Calcaneus. 5, Plantar aponeurosis.

  • MRI of ankle, axial view, image 25.1, Flexor digitorum brevis muscle. 2, Abductor digiti minimi muscle.

  • MRI of ankle, coronal view, image 1.1, Navicular. 2, Talus. 3, Cuboid. 4, Peroneus longus tendon. 5, Abductor digiti minimi muscle. 6, Flexor digitorum brevis muscle. 7, Quadratus plantae muscle. 8, Abductor hallucis muscle.

  • MRI of ankle, coronal view, image 2.1, Navicular. 2, Talus. 3, Cuboid. 4, Abductor digiti minimi muscle. 5, Flexor digitorum brevis muscle. 6, Quadratus plantae muscle. 7, Abductor hallucis muscle.

  • MRI of ankle, coronal view, image 3.1, Navicular. 2, Talus. 3, Cuboid. 4, Abductor digiti minimi muscle. 5, Flexor digitorum brevis muscle. 6, Quadratus plantae muscle. 7, Abductor hallucis muscle.

  • MRI of ankle, coronal view, image 4.1, Navicular. 2, Talus. 3, Abductor digiti minimi muscle. 4, Flexor digitorum brevis muscle. 5, Quadratus plantae muscle. 6, Abductor hallucis muscle.

  • MRI of ankle, coronal view, image 5.1, Talus. 2, Calcaneus. 3, Abductor digiti minimi muscle. 4, Flexor digitorum brevis muscle 5, Quadratus plantae muscle. 6, Abductor hallucis muscle.

  • MRI of ankle, coronal view, image 6.1, Talus. 2, Calcaneus. 3, Abductor digiti minimi muscle. 4, Flexor digitorum brevis muscle 5, Quadratus plantae muscle. 6, Abductor hallucis muscle. 7, Flexor hallucis longus tendon.

  • MRI of ankle, coronal view, image 7.1, Tibia. 2, Talus. 3, Calcaneus. 4, Abductor digiti minimi muscle. 5, Peroneus longus tendon. 6, Flexor digitorum brevis muscle 7, Quadratus plantae muscle. 8, Abductor hallucis muscle.

  • MRI of ankle, coronal view, image 8.1, Tibia. 2, Calcaneus. 3, Abductor digiti minimi muscle. 4, Flexor digitorum brevis muscle. 5, Quadratus plantae muscle. 6, Abductor hallucis muscle. 7, Flexor hallucis longus tendon. 8, Talus.

  • MRI of ankle, coronal view, image 9.1, Tibia. 2, Fibula (lateral malleolus). 3, Talus. 4, Calcaneus. 5, Abductor digiti minimi muscle. 6, Flexor digitorum brevis muscle. 7, Quadratus plantae muscle. 8, Abductor hallucis muscle.

  • MRI of ankle, coronal view, image 10.1, Tibia. 2, Fibula (lateral malleolus). 3, Talus. 4, Peroneus brevis and peroneus longus tendons. 5, Abductor digiti minimi muscle. 6, Flexor digitorum brevis muscle. 7, Quadratus plantae muscle. 8, Abductor hallucis muscle.

  • MRI of ankle, coronal view, image 11.1, Tibia (Medial malleolus). 2, Fibula (lateral malleolus). 3, Talus. 4, Calcaneus. 5, Abductor digiti minimi muscle. 6, Flexor digitorum brevis muscle. 7, Quadratus plantae muscle. 8, Abductor hallucis muscle. 9, Tibiocalcaneal ligament.

  • MRI of ankle, coronal view, image 12.1, Tibia (Medial malleolus). 2, Fibula (lateral malleolus). 3, Talus. 4, Peroneus brevis and peroneus longus tendons. 5, Calcaneus. 6, Abductor digiti minimi muscle. 7, Plantar aponeurosis. 8, Quadratus plantae muscle. 9, Abductor hallucis muscle. 10, Flexor hallucis longus tendon. 11, Tibiotalar ligament.

  • MRI of ankle, coronal view, image 38.1, Tibia. 2, Fibula. 3, Talofibular ligament. 4, Peroneus longus tendon. 5, Calcaneus. 6, Abductor digiti minimi muscle. 7, Flexor digitorum brevis muscle. 8, Quadratus plantae muscle. 9, Abductor hallucis muscle. 10, Talus.

  • MRI of ankle, coronal view, image 39.1, Tibia. 2, Talus. 3, Fibula. 4, Calcaneus. 5, Plantar aponeurosis. 6, Quadratus plantae muscle. 7, Abductor hallucis muscle. 8, Flexor digitorum longus tendon. 9, Tibialis posterior tendon.

  • MRI of ankle, coronal view, image 40.1, Tibia. 2, Calcaneus. 3, Quadratus plantae muscle. 4, Abductor hallucis muscle. 5, Talus.

  • MRI of ankle, coronal view, image 16.1, Tibia. 2, Calcaneus. 3, Abductor hallucis muscle. 4, Quadratus plantae muscle. 5, Talus.

  • MRI of ankle, coronal view, image 17.1, Abductor hallucis muscle. 2, Quadratus plantae muscle. 3, Flexor digitorum longus tendon. 4, Peroneus brevis muscle. 5, Flexor hallucis longus muscle. 6, Calcaneus.

  • MRI of ankle, coronal view, image 18.1, Flexor hallucis longus muscle. 2, Peroneus brevis muscle. 3, Quadratus plantae muscle. 4, Calcaneus.

  • MRI of ankle, coronal view, image 19.1, Flexor hallucis longus muscle. 2, Calcaneus. 3, Quadratus plantae muscle.

  • MRI of ankle, coronal view, image 20.1, Soleus muscle. 2, Flexor hallucis longus muscle. 3, Calcaneus. 4, Quadratus plantae muscle.

  • MRI of ankle, coronal view, image 21.1, Soleus muscle. 2, Calcaneus. 3, Quadratus plantae muscle.

  • MRI of ankle, coronal view, image 22.1, Soleus muscle. 2, Calcaneus. 3, Quadratus plantae muscle.

  • MRI of ankle, coronal view, image 23.1, Soleus muscle. 2, Achiles tendon. 3, Calcaneus.

  • MRI of ankle, coronal view, image 24.1, Soleus muscle. 2, Achiles tendon. 3, Calcaneus.

  • MRI of ankle, coronal view, image 25.1, Achiles tendon. 2, Calcaneus.

  • MRI of ankle, sagittal view, image 1.1, Tibia (medial malleolus). 2, Navicular. 3, Tibialis anterior tendon. 4, Medial cuneiform. 5, 1st metatarsal. 6, Flexor hallucis brevis muscle. 7, Abductor hallucis muscle. 8, Tibialis posterior tendon.

  • MRI of ankle, sagittal view, image 2.1, Tibia. 2, Navicular. 3, Tibialis anterior tendon. 4, Medial cuneiform. 5, 1st metatarsal. 6, Flexor hallucis brevis muscle. 7, Abductor hallucis muscle

  • MRI of ankle, sagittal view, image 3.1, Tibia. 2, Talus. 3, Tibialis anterior tendon. 4, Navicular. 5, Medial cuneiform. 6, 1st metatarsal.

  • MRI of ankle, sagittal view, image 4.1, Tibia. 2, Talus. 3, Tibialis anterior tendon. 4, Navicular. 5, Medial cuneiform. 6, 1st metatarsal.

  • MRI of ankle, sagittal view, image 5.1, Tibia. 2, Talus. 3, Tibialis anterior tendon. 4, Navicular. 5, Medial cuneiform. 6, Flexor digitorum brevis muscle. 7, Flexor hallucis longus tendon & Flexor digitorum longus tendon.

  • MRI of ankle, sagittal view, image 6.1, Tibia. 2, Tibialis anterior tendon. 3, Navicular. 4, Flexor digitorum brevis muscle. 5, Calcaneus. 6, Talus.

  • MRI of ankle, sagittal view, image 7.1, Tibia. 2, Tibialis anterior tendon. 3, Talus. 4, Navicular. 5, Intermediate cuneiform. 6, 2nd metatarsal. 7, Flexor digitorum brevis muscle. 8, Plantar aponeurosis. 9, Quadratus plantae muscle . 10, Calcaneus. 11, Flexor hallucis longus tendon. 12, Flexor digitorum longus tendon.

  • MRI of ankle, sagittal view, image 8.1, Tibia. 2, Tendon & muscle Tibialis anterior / Extensor hallucis longus . 3, Talus. 4, Sinus Tarsi. 5, Navicular. 6, Intermediate cuneiform. 7, 2nd metatarsal. 8, Flexor digitorum brevis muscle. 9, Quadratus plantae muscle .. 10, Achilles tendon 11, Calcaneus.. 12, Flexor hallucis longus tendon.

  • MRI of ankle, sagittal view, image 9.1, Tibia. 2, Tendon & muscle Tibialis anterior / Extensor hallucis longus . 3, Talus. 4, Navicular. 5, Plantar aponeurosis. 6, Calcaneus. 7, Achilles tendon. 8, Flexor hallucis longus tendon & muscle. 9, Soleus muscle.

  • MRI of ankle, sagittal view, image 10.1, Tibia. 2, Tendon & muscle Tibialis anterior / Extensor hallucis longus . 3, Talus. 4, Navicular. 5, Cuneiform. 6, Abductor hallucis muscle. 7, Peroneus longus tendon. 8, Calcaneus. 9, Achilles tendon. 10, Flexor hallucis longus tendon & muscle. 11, Soleus muscle.

  • MRI of ankle, sagittal view, image 11.1, Tibia. 2, Tendon & muscle Tibialis anterior / Extensor hallucis longus . 3, Talus 4, Cuneiform. 5, Metatarsal. 6, Peroneus longus tendon. 7, Calcaneus. 8, Achilles tendon. 9, Flexor hallucis longus tendon & muscle. 10, Soleus muscle.

  • MRI of ankle, sagittal view, image 12.1, Tibia. 2, Talus. 3, Cuboid. 4, Cuneiform. 5, Metatarsal. 6, Abductor hallucis muscle. 7, Calcaneus. 8, Achilles tendon. 9, Flexor hallucis longus tendon & muscle.

  • MRI of ankle, sagittal view, image 13.1, Extensor digitorum longus muscle. 2, Tibia. 3, Cuboid. 4, 4th metatarsal. 5, Abductor digiti minimi muscle. 6, Calcaneus. 7, Talus.

  • MRI of ankle, sagittal view, image 14.1, Extensor digitorum longus muscle. 2, Tibia. 3, Cuboid. 4, Metatarsal. 5, Flexor digitorum brevis muscle. 6, Abductor digiti minimi muscle. 7, Calcaneus. 8, Fibula. 9, Peroneus longus muscle.

  • MRI of ankle, sagittal view, image 15.1, Extensor digitorum longus muscle. 2, Fibula. 3, Metatarsal. 4, Abductor digiti minimi muscle. 5, Peroneus longus muscle.

  • MRI of ankle, sagittal view, image 16.1, Extensor digitorum longus muscle. 2, Fibula. 3, Peroneus longus tendon. & Peroneus brevis tendon. 4, Metatarsal. 5, Abductor digiti minimi muscle. 6, Peroneus longus muscle.

  • 1, Fibula. 2, Peroneus longus tendon. 3, 5th metatarsal. 4, Peroneus brevis muscle.

Radiologists perform ankle imaging to assess injuries of the foot and ankle anatomy. Experts analyze the different imaging techniques to identify better diseases associated with the foot and ankle, including diabetic foot ulcers and abnormal growths in the foot and ankle(1).

How Does Ankle MRI Work?

Routine ankle magnetic resonance imaging (MRI) tests involve taking images of the foot and ankle in the axial, coronal, and sagittal planes parallel to the tabletop(2).

Axial images are parallel to the long axis of the metatarsal (mid-foot) bones. Coronal images are perpendicular to the long axis of the metatarsals. Meanwhile, sagittal images are lateral, meaning they divide the foot into its left and right sides).

Compared to CT scans, ultrasounds, or X-rays, MRI tests give doctors a more detailed look at soft-tissue structures. The images allow the experts to assess a variety of soft-tissue disorders of ligaments and tendons.

During an MRI test, patients are supine (lying face upward) with their foot in about a 20-degree plantar flexion (moving the foot downward away from the body, the way a ballet dancer stands on their toes). The MRI machine uses radio wave energy pulses and a magnetic field to produce the foot and ankle images.

The imaging process allows the magnetic field to find changes in the organ and tissue structures, identifying any sprains, ruptures, dislocations, or synovial disorders (conditions that affect the thin tissue layer lining the joints).

MRI pictures are digital, allowing other doctors to review the scanned images for further study remotely.

For physical copies of the MRI pictures, technicians may use a contrast material during the MRI test to highlight specific structures. Contrast materials are substances that help show areas of infection or inflammation by making structures appear more clearly.

Osseous Lesions

Ankle MRI includes assessments of the foot’s bone structures. The foot has 26 bones (tarsal, metatarsal, and phalanges), which subdivide into groups, known as the hindfoot, midfoot, and forefoot(3).

Assessing these parts help doctors identify the following diseases:

  • Osteonecrosis: Also known as avascular necrosis, this disease is the death of bone tissue due to a lack of blood supply. Osteonecrosis can lead to tiny breaks in the bone and the bone’s eventual collapse(4).

Ankle and foot osteonecrosis typically occurs in the talus due to talar neck fractures with a vascular compromise of the bone at the sinus tarsi level (tube between the ankle and heel)(5)

  • Osteochondral Fractures: Experts consider osteochondral fractures as injuries that damage the cartilage. These conditions may also affect the underlying subchondral bone (bone sitting underneath cartilage in a joint)(6).

Ankle osteochondral fractures usually appear in the talar dome, most frequently in the middle third of the lateral border and the posterior third of the medial border(7).

  • Stress Fractures and Acute Posttraumatic Fractures: A fracture is a break in the bone that may occur after falls, sports injuries, or vehicular accidents. Experts find that MRI is more sensitive than conventional radiography. MRI can also be more specific than bone scintigraphy in detecting occult fractures(8).
  • Bone Contusion: Bone contusions or bone bruises are related to the trabecular bone (spongy, light, and porous bone) and edema (swelling) or hemorrhage within the bone marrow. Constant stress placed on a contused bone may lead to complete fracture(9).

Tendon Injuries

Tendon injuries have six categories: dislocation, entrapment, peritendinosis, rupture, tendinosis, and tenosynovitis(10).

These conditions often coexist and overlap in their clinical, gross, and histologic manifestations, making them indistinguishable at MRI tests(11).

Some conditions that doctors can assess from an MRI test may include:

  • Flexor Hallucis Longus Tendon Injuries: The flexor hallucis longus (FHL) tendon is susceptible to injuries along the entire course, from the ankle’s posterior aspect to the insertion into the great toe’s distal phalanx base(12).

Experts note various lacerations, ruptures, longitudinal splits, and stenosing tenosynovitis among the injuries.

MRI tests may find FHL injuries better through axial and sagittal MR images(13).

  • Peroneal Tendon Injuries: Injuries to the peroneal tendons include dislocation, peritendinosis, rupture, tendinosis, and tenosynovitis(14).

MRI scans characterize findings of peritendinosis as scarring around the tendons. Meanwhile, tenosynovitis manifests as the fluid within the common tendon sheath(15).

  • Posterior Tibial Tendon Dysfunction: Posterior tibial tendon dysfunction is primarily soft tissue tendinosis of the posterior tibialis. This condition may lead to altered foot biomechanics. Most experts agree that it is a progressive disorder(16).
  • Achilles Tendon Injuries: Achilles tendon injuries are the most common tendon ruptures of the foot are. These injuries usually occur in individuals who are only intermittently active(17).

References

  1. Bae, W. C., Ruangchaijatuporn, T., & Chung, C. B. (2017). New Techniques in MR Imaging of the Ankle and Foot. Magnetic resonance imaging clinics of North America, 25(1), 211–225. https://doi.org/10.1016/j.mric.2016.08.009
  2. Rosenberg, Zehava S., Beltran, Javier, Bencardino, Jenny T. MR Imaging of the Ankle and Foot. From the RSNA Refresher Courses. 2000 October. Retrieved from https://pubs.rsna.org/doi/full/10.1148/radiographics.20.suppl_1.g00oc26s153
  3. Ficke J, Byerly DW. Anatomy, Bony Pelvis and Lower Limb, Foot. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546698/
  4. Avascular necrosis. Mayo Clinic.  2020 April 22. Retrieved from https://www.mayoclinic.org/diseases-conditions/avascular-necrosis/symptoms-causes/syc-20369859
  5. Resnick D, Niwayama G. Osteonecrosis: diagnostic techniques, specific situations, and complications. In: Resnick D, Niwayama G, eds. Diagnosis of bone and joint disorders. Philadelphia, Pa: Saunders, 1988; 3238–3288.
  6. Pedersen, M. E., DaCambra, M. P., Jibri, Z., Dhillon, S., Jen, H., & Jomha, N. M. (2015). Acute Osteochondral Fractures in the Lower Extremities – Approach to Identification and Treatment. The open orthopaedics journal, 9, 463–474. https://doi.org/10.2174/1874325001509010463
  7. Flick AB, Gould N. Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. Foot Ankle 1985; 5:165–185.
  8. Deutsch AL, Mink JH, Waxman AD. Occult fracture of the proximal femur: MR imaging. Radiology1989; 1709:113–116.
  9. Lynch TC, Crues JV III, Morgan FW, Sheehan WE, Harter LP, Ryu R. Bone abnormalities of the knee: prevalence and significance at MR imaging. Radiology 1989; 171:761–766.
  10. Trevino S, Baumhauer JF. Tendon injuries of the foot and ankle. Clin Sports Med 1992; 11:727–739.
  11. Bencardino J, Rosenberg ZS, Delfaut E. MR imaging of sports injuries of the foot and ankle. Magn Reson Imaging Clin N Am 1999; 7:131–149.
  12. Boruta, P. M., & Beauperthuy, G. D. (1997). Partial tear of the flexor hallucis longus at the knot of Henry: presentation of three cases. Foot & ankle international, 18(4), 243–246. https://doi.org/10.1177/107110079701800411
  13. Karasick D, Schweitzer ME. The os trigonum syndrome: imaging features. AJR Am J Roentgenol 1996; 166:125–129.
  14. Sanmarco GJ. Peroneal tendon injuries. Orthop Clin North Am 1994; 25:135–145.
  15. Mota J, Rosenberg ZS. MRI of the peroneal tendons. Top Magn Reson Imaging 1998; 9:273–285.
  16. Ling, S. K., & Lui, T. H. (2017). Posterior Tibial Tendon Dysfunction: An Overview. The open orthopaedics journal, 11, 714–723. https://doi.org/10.2174/1874325001711010714
  17. Shamrock AG, Varacallo M. Achilles Tendon Rupture. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430844/

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