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MRI of the ankle: preparation and technique
Last reviewed: 03.07.2025
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Today, magnetic resonance imaging is increasingly used to diagnose various internal and external injuries and traumas. It is used in various areas of medical practice: from gastroenterology and neurosurgery to traumatology and orthopedics. It makes it possible to determine any pathology with high accuracy. Today, MRI of the ankle is becoming increasingly relevant and important. This is a highly informative, non-invasive method that allows you to identify the cause and degree of development of degenerative and inflammatory processes in the joint.
Today, rheumatologists and traumatologists increasingly encounter injuries and diseases of the ankle joint, which is explained by the fact that it is subject to the highest load. It takes part in all types of limb movements, takes the main load. It supports the weight of a person. Injuries and diseases develop especially often in women, since they often wear high heels. Athletes, dancers, and professional trainers are also most at risk of injury or development of ankle disease.
What does an MRI of the ankle show?
MRI can show a lot to a specialist. With the help of this method, it is possible to visualize the main structures of the joint, thanks to which it is possible to make a correct diagnosis and select the necessary treatment quite quickly. It is possible to diagnose pathological conditions, identify injuries. It gives a lot of useful information when diagnosing bones, tendons, ligaments and bones of the examined joint. It is also possible to promptly identify tumors of any genesis and stage, arthritis, bleeding and bruises.
The advantage of the method is the ability to identify old hematomas and injuries, which is widely used in forensic practice during examinations.
The method can show damage of various nature in the ankle, Achilles tendon. It is the tendons and ligaments located here that provide flexibility and mobility of the joint, giving it the ability to perform its entire range of motion.
MRI can reveal ruptures and complete ruptures of ligaments and tendons of the joint, their stretching, mechanical damage, and inflammation. It makes it possible to identify the slightest changes in the structure of cartilage tissue. Various thinnings, involutions, and degenerative processes are also well visualized.
The procedure provides good visualization of the ankle and foot bones. You can even view the talus and calcaneus, which are almost impossible to examine using other methods. This is practically the only method for determining fractures of these bones. You can also detect bruises, dislocations, and signs of osteoarthritis, arthritis, osteoporosis.
The method is very informative when preparing for operations, as it allows to detect the presence and localization of tumors, visualizes blood and exudate accumulations in soft tissues, around the joint, or inside it. Allows to assess the condition of the distal parts of the tibia and fibula, as well as the muscles of the foot. It is possible to additionally introduce a contrast agent, which will allow to examine the structure of the ankle in detail and determine even minimal morphological changes. It is possible to visualize dystrophic, degenerative, inflammatory processes.
Indications for the procedure
The procedure is prescribed when it is necessary to examine the ankle joint, in particular, in case of injuries to tendons, ligaments, cartilages. The procedure is informative when it is necessary to detect a fracture, dislocation. This is practically the only method that makes it possible to detect tumors at the early stages of their development. Both soft tissue tumors and bone and joint tumors can be visualized.
Prescribed for diagnostics of infectious and inflammatory processes, necrosis. Allows to detect false joints and unconsolidated fractures, diseases such as arthritis, arthrosis, tendinitis, tendinosis.
It is prescribed in the presence of congenital anomalies and pathologies, with the development of pain, swelling, redness in the ankle area. It is used as an additional method of examination when other methods are insufficiently informative. For example, to clarify the diagnosis if a pathology was detected on an X-ray, but was not finally differentiated. It is prescribed when the range of motion in the joint area is reduced, the genesis of joint pain is unclear. It is mandatory to use in preparation for operations.
[ Preparation
Before the procedure, the patient must remove his/her clothes and wear special disposable clothes. It is allowed to stay in your clothes only if they are loose-fitting and do not contain metal parts or inserts.
The protocols for conducting the study do not specify the mechanism for organizing nutrition before and after the procedure. Based on practice, doctors recommend refraining from eating for several hours before the study. This is especially important if a study with contrast is planned. It is also important to inform the doctor about any allergic reactions or intolerance to certain components before the procedure. It is also necessary to inform the doctor about bronchial asthma.
The contrast agent used contains a metallic component – gadolinium. It has virtually no side effects and does not entail complications. However, people with severe somatic diseases, heart and kidney pathologies are better off not using it. At least, the presence of such concomitant diseases must be reported to the archa in advance.
It is important to obtain information about pregnancy in advance. Therefore, if a woman has doubts, it is necessary to take a pregnancy test when preparing for the study. An hCG test will be sufficient.
Before the procedure, the patient is explained what will be examined and for what purpose, what procedures will be used. It is important to inform the patient about the expected results, risks, consequences of the procedure. In case of claustrophobia, the use of open-type devices is recommended. For children, preliminary sedation is mandatory, which will allow the child to lie quietly and motionless, which will avoid injuries during the procedure.
It is absolutely necessary to remove and discard all objects that contain metal. You need to make sure that all jewelry, watches, business cards, and credit cards are removed. Also remove hearing aids, dentures, and piercings. Pens, pocket knives, glasses, and any other items are laid out.
Technique MRI of the ankle joint
Traditionally, a closed-type MRI device is always used. It looks like a large cylindrical tube. Which is surrounded by a magnet. During the procedure, the patient is placed on a movable table. Which moves towards the center of the magnet.
There are also open-type MRIs, but they are less informative, since the magnet does not completely surround the patient. On the sides, he remains without a magnetic part. This method is used only if the person has claustrophobia or is very heavy.
When examining the ankle joint, the coil is placed directly on the joint being examined. The patient must lie down and remain motionless. On average, the procedure lasts from 30 to 40 minutes. If the examination is performed with contrast, the procedure lasts longer.
The procedure is painless. Some patients note the appearance of specific sensations in the area where the examination is being conducted. This may be tingling, vibration, warmth, or a slight burning sensation. Each person has their own impressions. This is normal, and there is no need to worry. This is how the individual tissue reaction to magnetic influence manifests itself.
During the examination, the patient is alone in the equipment room, but there is a two-way audio connection between the doctor and the patient. The doctor sees the patient. No adaptation is required after the procedure.
Today, it is possible to perform MRI of the ankle using small-sized devices that do not require the entire person to be placed in the chamber. Only the necessary joint is examined. The image is of fairly high quality.
MRI of ankle ligaments
There is often a need to examine the ankle ligaments. The most effective method for this is MRI. It allows for a comprehensive examination of the Achilles tendon, assessing its condition, and identifying possible pathologies. It is used to detect ruptures and tears. Sometimes other ligaments are examined if they cause pain or if there is a suspicion of a pathological process. The deltoid ligament, which stabilizes the joint, is often examined. Which ligament is damaged can often only be determined by the results of an MRI scan.
Contraindications to the procedure
The MRI procedure cannot be performed if the patient has various implants, implanted electronic devices, or tattoos that contain iron or metallic impurities.
MRI is contraindicated in the presence of pacemakers, endoprostheses, defibrillators. It cannot be performed with artificial heart valves, with some types of clips that are used for cerebral aneurysms, with metal spirals that are placed within blood vessels.
Contraindications include implanted nerve stimulators, metal pumps, pins, screws, plates, surgical staples. Also, the procedure is not performed if there is any metal part in the human body, such as a bullet or shrapnel. This is due to the fact that the magnetic field will attract the metal to itself and displace it, which can lead to tissue damage and rupture of blood vessels.
Complications after the procedure
The procedure has no complications. The exception is cases of non-compliance with safety rules. If the procedure is carried out in the presence of contraindications, serious complications are possible, including death.
This is due to the natural action of magnetic particles: if there are metal elements or implants in the human body, they are attracted by the magnetic field. This can lead to their displacement, breakage. As a result, tissue and vessel damage, bleeding, and irreversible consequences can occur.
Nephrogenic systemic fibrosis is now recognized as a possible complication after the introduction of a large amount of contrast agent. But this effect is extremely rare. It occurs more often in patients with renal failure or other serious disorders of the structure and function of the kidneys.
Consequences after the procedure
The procedure is absolutely painless and harmless and has no consequences. Adaptation after the procedure is not required. The person can immediately go to rest or do their usual activities. In rare cases, an allergic reaction to the injected contrast agents may develop. This is observed if the person suffers from an allergy and has not warned in advance. An attack of claustrophobia is possible if the person suffers from this disease. Nervous attacks and seizures occur in people with serious neurological disorders and severe mental states.
Reviews
If you analyze the reviews, you can see both positive and negative reviews. As many specialists who use this method in their diagnostic practice note, MRI is a highly informative and accurate method. A big plus is that it is non-invasive and does not require any preliminary preparation. Provides a high level of visualization and does not allow the use of ionizing radiation.
It is a valuable method for diagnosing a wide range of conditions, including inflammation, damage, and trauma. It is almost always used before surgical interventions. It allows the surgeon to obtain the most accurate information and determine the scope of surgical intervention. It is possible to diagnose complex fractures, even in cases where X-rays do not give any results. It is also possible to detect those anomalies that are not visible when examined by other methods.
At the same time, risks associated with this procedure are also noted. Sometimes sedation is required, since a person may have claustrophobia or cannot stand still for the duration of the procedure. Sedation is also used for children. Sometimes a person is too nervous, the device seems frightening to him, so sedatives have to be administered. There is always a risk of oversedation.
Although the magnetic field itself does not have a negative effect on a person, implanted devices or metal elements located in the human body can cause serious damage. There is also always a risk of developing an allergic reaction, especially when using a contrast agent. But usually such reactions are quickly stopped by the introduction of antiallergic drugs. There is always a risk of developing an attack of claustrophobia when using a closed-type device.
Patients describe ankle MRI as a painless procedure. Some are confused by the need to immerse themselves in the device, which causes anxiety. After the procedure, there is no discomfort, and the patient feels well.