Visualization of Ankle Tendons and Ligaments with MR Imaging: Influence of Passive Positioning

Abstract

Purpose: To determine if passive positioning of the ankle influences the MR imaging appearance of ankle tendons and ligaments. Methods: A positioning device was used during imaging of 10 volunteers. Axial and coronal T1-weighted images were acquired in six positions of the ankle, and the appearance of the tendons and lateral ligaments was subjectively evaluated. Results: The peroneus longus (PL), peroneus brevis (PB), anterior tibialis (AT), extensor digitorum longus (EDL), and extensor hallucis longus (EHL) tendons were best visualized in 20° of plantarflexion and 20° of inversion (p<0.0001). The anterior talofibular (ATF) and calcaneofibular (CF) ligaments were best seen in 20° of plantarflexion (p<0.0001). Ten degrees of dorsiflexion was the least useful imaging plane for all of the aforementioned structures. Conclusion: When there is clinical concern regarding pathology of a specific structure about the ankle, passive positioning may allow optimal evaluation.