Magnetic resonance imaging (MRI) of the ankle joint is an advanced imaging study that uses a strong magnetic field and radio waves to provide a detailed assessment of ankle joint structures, including bone, tendons, ligaments, muscles as well as connective and vascular tissue. It is a key diagnostic tool that enables lesions and various pathological conditions that can affect the function of the foot and ankle to be detected.
Indications to the examination
MRI of the ankle joint is recommended for a variety of symptoms and conditions that may necessitate a detailed diagnosis. Indications for a MRI scan of the ankle joint include:
- pain and swelling of the ankle joint without a clear cause;
- suspected damage to soft joint structures such as the Achilles tendon or ligaments;
- assessment of bone condition after trauma, for instance, in cases of fractures;
- diagnosis of degenerative and inflammatory changes, such as arthritis;
- detecting free bodies in the joint space, which may be a source of pain and reduced mobility.
MRI of the ankle joint also allows assessment of possible lesions, both benign and malignant, which can cause nonspecific symptoms such as swelling, pain, or changes in the tissue structure of the joint.
Additionally, MRI is invaluable in planning surgical interventions, as it provides high-resolution images that enable lesions to be accurately located and the most effective treatment to be planned. Unlike X-ray, MRI can show both soft tissue and bone in a single examination, which is extremely helpful in comprehensive ankle joint evaluation.
Specialists in various fields, most commonly orthopaedists, rheumatologists or sports rehabilitation specialists, can refer patients for an MRI scan to get a clear picture of the underlying cause of their condition and determine an appropriate treatment plan.
Contraindications to ankle joint MRI
MRI of the ankle joint is a safe examination, but there are certain situations in which this imaging modality requires additional consultation, and in some cases it cannot be used. Special attention should be paid in the following cases:
- the presence in the patient’s body of metal implants and electronic medical devices (e.g., pacemaker, cochlear implants);
- severe claustrophobia, unless the patient chooses to take sedatives;
- the first trimester of pregnancy, unless the examination is absolutely medically necessary.
How to prepare for an MRI scan
It is recommended that the patient present for the examination in loose clothing without metal parts and remove all items such as jewellery or watches. Moreover, the patient should not eat or drink for three hours before the examination.
If the administration of a contrast agent is planned, the patient should inform the doctor of any allergies, especially to gadolinium, and of any history of renal failure. The patient may also be asked to undergo a creatinine level test to ensure that his or her kidneys are able to process the contrast agent.
Course of the examination
During the examination, the patient lies on a moving table that moves inside the MRI scanner. It is important that the patient remain still throughout the procedure, which usually takes 30 to 60 minutes. If the patient suffers from claustrophobia, sedatives may be used.
Most MRI examinations of the ankle joint are performed using a contrast agent, which may be introduced either directly into the joint (ankle arthrography) or intravenously. However, there are specific contraindications to intravenous contrast administration, such as elevated creatinine levels (usually above 1.3 mg/dl) or reduced glomerular filtration rate (eGFR below 30 ml/min/m2) – these parameters are used to assess renal function.
After an examination that involves contrast administration, patients are advised to drink plenty of fluids, which helps the contrast agent to be removed from the body faster. Contrast administration may sometimes result in side effects such as nausea, rash, warmth, itchy skin or headache, although these are usually mild and transient reactions.
Ankle joint MRI results are usually available within a few days. The radiologist analyses the images and provides a report of the findings to the referring physician who will discuss the results with the patient and recommend further treatment, which may include medication, physiotherapy and sometimes surgical intervention.
Examination price
The cost of an ankle MRI can vary widely depending on the facility and the region, with prices ranging from PLN 500 to PLN 1,000. This examination may be reimbursed by the National Health Fund, which requires a referral from a doctor. However, many patients choose to undergo the examination at a private facility because of long waiting times at public medical facilities.
*ATTENTION! The information contained in this article is for informational purposes and is not a substitute for professional medical advice. Each case should be evaluated individually by a doctor. Consult with him or her before making any health decisions.