MRI of the ankle (an approach)

Last revised by Joachim Feger on 16 Sep 2021

MRI of the ankle is one of the more frequent examinations faced in daily radiological practice. This approach is an example of how to create a radiological report of an MRI of the ankle with coverage of the most common anatomical sites of possible pathology, within the ankle without claim for completeness.

Systematic review

A systematic review of the MRI of the ankle is essential since ankle anatomy itself is rather complex, pathologies and injury patterns are manifold and only rarely lead to an abnormality of a single structure but rather show diverse findings which might need to be addressed in further patient management.


The bony structures of the ankle, the distal tibia, distal fibula, talus, calcaneus, navicular and cuboid bone as well as the three cuneiforms and the bases of the metatarsal bones and their alignment are assessed:

Distal tibiofibular joint

Assessment of the distal tibiofibular syndesmosis:

Tibiotalar joint

Assessment of the following structures:

Subtalar joint and sinus tarsi
Midtarsal joint
Posteromedial compartment / tarsal tunnel

Assessment of the following structures:

Peroneal compartment

Assessment of the following structures:

Anterior compartment
Achilles tendon and calcaneus
Plantar fascia,  plantar soft tissues and muscles

Common pathology

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