The increasing technological advances in MR imaging continue to expand the clinical applications and increase the diagnostic accuracy of this modality. The MR evaluation of the foot and ankle has benefited substantially from the implementation of 3T scanners and associated imaging techniques. From this topical review, the main points to summarize 3T scanning include: • The implementation of 3T MR scanners, combined with specialized coils and novel imaging techniques, have yielded superior image quality with potential for enhanced diagnostic accuracy. • A good quality 3T MR imaging examination encompasses predominantly spin-echo type contrast, thin section T1-weighted (T1W) and fsT2W images, uniform fat suppression, higher echo times to avoid magic angle artifacts and higher resolution. • Metal artifacts markedly degrade imaging; therefore in patients with hardware, in the field of view, 1.5T MR scanning is preferred. • 3T images can depict the various bundles of the small ankle ligaments and tendons, such as the various components of the spring ligament, Lisfranc ligament, bifurcate ligament, as well as the superficial and deep deltoid ligaments, which are visualized with consistency. • Tendon and ligament injuries as well as nerve entrapments are better depicted on 3T MR imaging as opposed to low-field scanner images. • 3T MR imaging better depicts the cartilage fissures, flaps and areas of delamination with secondary bone marrow changes in native or repaired osteochondral lesions as opposed to low-field MR images, in which bony changes are the predominant discernable finding implying overlying cartilage abnormality.
[Show abstract][Hide abstract] ABSTRACT: This article reviews current magnetic resonance imaging (MR imaging) techniques for imaging the lower extremity, focusing on imaging of the knee, ankle, and hip joints. Recent advancements in MR imaging include imaging at 7 T, using multiple receiver channels, T2* imaging, and metal suppression techniques, allowing more detailed visualization of complex anatomy, evaluation of morphologic changes within articular cartilage, and imaging around orthopedic hardware.
Radiologic Clinics of North America 05/2013; 51(3):529-45. DOI:10.1016/j.rcl.2012.12.001 · 1.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Osteoarthritis (OA) is defined as the syndrome of joint pain and dysfunction caused by substantial joint degeneration. In general, OA is the most common joint disease and is one of the most frequent and symptomatic health problems for middle-aged and older people: OA disables more than 10% of people who are older than 60 years. This article reviews the etiology of ankle OA, and describes the onset and development of posttraumatic ankle OA, the most common form of OA in the tibiotalar joint. Various methods of clinical and radiographic assessment are described in detail.
[Show abstract][Hide abstract] ABSTRACT: Patients with posttraumatic ankle osteoarthritis (OA) typically present with asymmetric involvement of the tibiotalar joint, resulting in valgus or varus deformity of the ankle and hindfoot. Without appropriate treatment, patients with asymmetric ankle OA typically develop full end-stage ankle OA. Ankles with valgus deformities suffer from a lateral joint overload with subsequent lateral tibiotalar joint degeneration, which causes further lateral load shift. In these cases patients may benefit from joint-preserving realignment surgery to unload the degenerated lateral area and normalize joint biomechanics. This article describes the authors' algorithm for the treatment of patients with asymmetric valgus ankle OA.
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