Slide 1

ByAbdElrhman ElTurkishMRI of Ankle joint

The Plain of project Display

* 5 Min Anatomy .* 8 min The Technique .* 2 min Questions .

The Ankel Bones

TibiaFibulaTalus

The Ankle Ligaments

* 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 .

Deltoid Ligament

The Ankle Tendons

Achilles .Peroneal .Anterior Tibialis .Posterior Tibialis

The Indications of MRI Ankle

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 ) .

Indicate neuropathic joint.

Osteomeylitis talus talonavicular septic arthritis.

Tibialis tendon anterior acute injury

PTT :: Posterior tibial tendon tears

The Technique of MRI Ankle

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 .

Ankle Coil

Ankle coil

3 Survey ( Scout ) .

1- Sagittal ( T2 T1 )

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

2- Axial T2

* 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.

3- Coronal ( T2 T1 STIR )

* 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.

MRI Ankle Protocols . ( 1.5 Tesla )

THANK YOU