Why MRI in Ankle?
HIDEInteractive Transcript
0:01
Welcome to MRI Online. MRI of the ankle,
0:05
foot, and ankle, and eventually we'll
0:07
work our way down to the great toe.
0:10
They used to say, why MRI of the ankle?
0:13
An ankle sprain, just a sprain,
0:15
it's a clinical diagnosis, right?
0:17
Well, not so much.
0:19
They also used to say that MRI
0:21
of the skeleton wasn't very good.
0:24
Well, that's not true.
0:25
Not so much.
0:27
MRI of a skeleton shows innumerable fractures,
0:31
intramedullary, that you can almost never
0:34
see on conventional radiography, that actually
0:36
tell you what the mechanism of injury is
0:39
and lead you to the correct diagnosis.
0:42
And sometimes, even macro fractures show
0:45
up on MRI, and the plain films are often
0:48
negative with only soft tissue swelling.
0:51
So let's get back to some of the
0:53
Strengths and the whys of why we do MRI.
0:55
The soft tissues are the strength of MRI.
1:00
And perhaps in no other joint are the soft
1:03
tissues so critical in injuries as they are in
1:06
the ankle, where the ligaments, the anterior
1:10
talofibular ligament, and some of the other
1:12
lesser injured ligaments are critical to evaluate.
1:15
Now you might say, okay, I can do that with
1:18
a clinical physical examination, so what?
1:21
But there are other things that
1:23
go along with ankle sprains.
1:24
Like osteochondral defects, fibular
1:27
gutter syndrome, meniscoid lesions, all
1:30
of which you're going to learn about.
1:32
And these affect what the
1:33
treatment is going to be.
1:36
But there's, there's oh so much more.
1:38
There's a lot of soft tissues about the ankle.
1:41
There are tendons, medial, lateral,
1:44
extensor, dorsal, posterior.
1:47
Assessment of the Achilles for
1:48
whether you operate or don't operate.
1:50
Often depends on the MR findings.
1:54
And that's also true for almost
1:56
all the other tendons of the ankle.
1:59
The plantar fascia, a very nagging area
2:02
Of interest, very problematic clinically.
2:05
We can tell whether we have mild, moderate,
2:07
Severe plantar fasciitis, periostitis,
2:11
Accompanying stress fracture, and a transection
2:15
Of the plantar fascia which affects treatment.
2:19
There are certain masses about the foot and ankle
2:21
That have very characteristic appearances that
2:25
Allow you to slam the door on the diagnosis, one
2:27
Of which would be plantar fibromatosis, which is
2:30
Basically Dupuytren's contracture of the foot.
2:33
The decision as to whether to resect or
2:35
Leave alone, often based on purely MRI.
2:39
The decision as to whether to
2:41
Go after a Morton's neuroma,
2:43
Which is basically an entrapment neuropathy of
2:46
The digital nerve between the metatarsals is
2:49
Often based on both the clinical and the MR.
2:53
These are just a few examples of why MR
2:56
Has become the leading imaging modality
3:00
For examination of the ankle, the foot,
3:04
The midfoot, the toes, and the great toe.
3:08
Let's get started, shall we?
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
© 2024 MRI Online. All Rights Reserved.