High-Resolution 3-Tesla MRI in the Evaluation of Ankle and Hindfoot Pain: A Pictorial Review

Ankle joint is affected by a large gamut of pathologies ranging from traumatic to nontraumatic in origin. Although ankle radiographs continue to serve as the initial investigation of choice, magnetic resonance imaging (MRI), owing to its superior soft tissue resolution and noninvasive nature is the most important investigative tool to evaluate ankle and hindfoot pain. MRI allows excellent assessment of soft tissue structures like ligaments, tendons, fascia, neurovascular bundle, and cartilage. MRI can also be used in detection of osseous injuries like bone contusions, stress and insufficiency fractures, osteonecrosis, osteochondral defects, and transient bone marrow edema. In this pictorial essay, we aim to study the normal anatomy of ankle joint as well as demonstrate a spectrum of common pathologies affecting the ankle joint with their salient imaging features on MRI.