Ankle & Foot MRI: Tendons, Ligaments & Hidden Fractures
The ankle and foot hold many small tendons, ligaments and bones, and MRI sorts out the causes of pain that plain films and examination can’t localise.
Tendons & ligaments
- Achilles: tendinopathy, partial and full-thickness tears, and the gap in complete rupture.
- Tibialis posterior: dysfunction/tear, a key cause of acquired flatfoot.
- Peroneal tendons: tears, subluxation.
- Lateral ligaments: ATFL/CFL after inversion injury; syndesmosis (“high ankle”) sprains.
Bone & cartilage
MRI shows osteochondral lesions of the talus, occult and stress fractures (metatarsals, navicular, calcaneus) via marrow oedema before X-ray change, and avascular necrosis.
Marrow oedema is the recurring clue (stress reaction, occult fracture, or early arthropathy) and is invisible on plain films.
Soft-tissue & the diabetic foot
Plantar fasciitis, Morton’s neuroma, ganglia and masses are well seen. In the diabetic foot, MRI is the key test to distinguish osteomyelitis (marrow signal change, adjacent ulcer/sinus) from neuropathic (Charcot) change and to map collections.
Sources
- Donovan A, Schweitzer ME. Current concepts in imaging diabetic pedal osteomyelitis. Radiol Clin North Am reviews.
Educational summary for clinicians; correlate with exam. Not medical advice.
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