An MRI of the ankle provides images of ligaments, tendons, bones and soft tissues. The document outlines the major ligaments of the ankle joint and indications for an MRI such as fractures, tendon disorders and infections. It describes positioning the patient with their ankle in the coil at a 90 degree angle and securing it to prevent movement. Three scan planes are discussed - sagittal, axial and coronal - with specific sequences and positioning for each view.

1. By
AbdElrhman ElTurkish
MRI of Ankle
joint

4. Tibia
Fibula
Talus

6. * Anterior talofibular ligament
* Calcaneofibular ligament Lateral .
* Posterior talofibular ligament
* Anterior Tibiofibular Ligament .
* Posterior Tibiofibular Ligament .
* The deltoid ligament :
* tibiocalcanean . Medial .
* Posterior talotibial .
* Tibionavicular .
* Anterior talotibial .

8. Deltoid Ligament

10. Achilles .
Peroneal .
Anterior Tibialis .
Posterior Tibialis

13. Indications for Ankle MRI scan
* fractures .
* Synovial-based disorders ( eg. synovitis, tenosynovitis ) .
* Achilles tendon disorders (eg.tears, tendonitis, tendinopathy)
* Infections of bone, joint, or soft tissue (eg. osteomyelitis) .
* Osteochondral and articular cartilage abnormalities .
* Abnormalities of other hindfoot tendons .
* Neoplasms of bone, joint, or soft tissue .
* Posterior tibial tendon disorders .
* Peroneal tendon disorders .
* Intra-articular loose body .
* Sinus tarsi syndrome ( pain of the lateral side of the hindfoot, between the ankle and the heel ) .
* Avascular necrosis (the death of bone tissue due to a lack of blood supply ) .
* Osteomeylitis (an infection in a bone ) .

14. Indicate neuropathic
joint.

15. Osteomeylitis talus
talonavicular septic
arthritis.

16. Tibialis tendon anterior acute
injury

17. PTT :: Posterior tibial tendon tears

18. The Technique of MRI Ankle

19.  Positioning
 Position the patient in supine position with feet pointing
towards the magnet (feet first supine) .
 Position the ankle in the foot and ankle coil (use knee coil if
ankle coil is not available) and lock it properly (Ankle should be
at 90° position)
Securely tighten the foot using cushions to prevent movement .
 Give a pillow under the head for extra comfort .
 Centre the laser beam localiser over ankle joint .

20. Ankle Coil

21. Ankle coil

22. 3 Survey ( Scout ) .

23. 1- Sagittal ( T2 – T1 )

24. Plan the sagittal slices on the axial plane ;
angle the position block parallel to the medial and lateral
malleoli.

25. 2- Axial T2

26. * Plan the axial slices on the coronal plane;
angle the position block parallel to the mortise joint .
* Check the positioning block in the other two planes.

27. 3- Coronal ( T2 – T1 – STIR )

29. * Plan the coronal slices on the axial plane;
angle the position block perpendicular to the medial and lateral
malleoli.
* Check the positioning block in the other two planes.

30. MRI Ankle Protocols . ( 1.5 Tesla )

33. THANK YOU