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Musculoskeletal Imaging

E2426. Ankle and Hindfoot MRI: What Every Radiologist Needs to Know

Adler K1,2,  Rastogi A.1,2 1. University of Missouri - Kansas City, Kansas City, MO; 2. Saint Luke's Hospital, Kansas City, MO

Address correspondence to K. Adler (

Background Information: The ankle and hindfoot are common areas of pain, in both the acute and chronic settings. As many different etiologies can have similar clinical presentations, MRI is often required for diagnosis and to guide management. Although commonly performed, ankle and hindfoot MRI can be quite challenging for many radiologists because of the complex soft tissue and osseous anatomy present in this region, as well as the variety of etiologies that exist for patient symptoms. The purpose of this exhibit is to review pertinent ankle and hindfoot anatomy, with specific attention to common sites of pathology and the essential findings in these cases.

Educational Goals/Teaching Points: This exhibit reviews the anatomy and injury patterns of the ankle and hindfoot. Pertinent cases review acute as well as chronic overuse injuries of the tendons, ligaments, and other soft tissue structures about the ankle and hindfoot, as well as several osseous disorders which can be seen in this region. Case examples specifically illustrate commonly encountered pathology, with an emphasis on accurate reporting of pertinent findings to effectively communicate diagnosis and guide treatment decisions.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: We review various soft tissue injuries and pathology, including commonly affected tendons (such as the Achilles, peroneal, posterior tibial, and anterior tibial tendons), medial and lateral ankle ligaments, as well review the anatomy and injuries of the plantar fascia. Osseous conditions, such as osteochondral lesions and painful accessory syndromes, as well as miscellaneous inflammatory conditions, such as sinus tarsi syndrome, are also discussed and reviewed via case examples.

Conclusion: MRI plays a critical role in the evaluation of acute and chronic ankle and hindfoot pathology, which can result in significant patient pain and morbidity. It is essential for the radiologist to be comfortable with the complex osseous and soft tissue anatomy in this region, as well as the many potential etiologies of symptoms. This exhibit provides the viewer with a thorough review of both anatomy and commonly encountered pathology of the ankle and hindfoot, which will increase comfort level with these cases, and facilitate the accurate diagnosis and treatment of these conditions.