Ankle & Foot MRI — Tendons, Ligaments & Hidden Fractures

Ankle & Foot MRI

A complex web of small tendons, ligaments and bones — 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 — a common, high-stakes clinical question.

Reference: 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.