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MRI Ankle Without Contrast

MRNo contrastMSK

Indications

Ankle pain / instability
Tendon injury (Achilles, peroneal, posterior tibial)
Ligament tear (ATFL/CFL)
Osteochondral lesion of talus
Occult fracture / stress injury
Plantar fasciitis (foot/heel)

Patient prep

MRI safety screening
Extremity/ankle coil
Foot in neutral ~90° dorsiflexion (helps Achilles, peroneal tendons)

Contrast

None / non-contrast

Technique

Patient supine or prone, foot in dedicated extremity coil, ankle neutral
Axial prescribed perpendicular to tibial shaft; oblique to display tendons
Combine T1/PD anatomy with fluid-sensitive fat-sat/STIR
Small FOV (~14-16 cm), thin slices 3-4 mm

Series / Sequences

#	Series / Sequence	Plane	Weighting / Recon	Thickness	Notes
1	Sag T1 or PD	sagittal	T1/PD	3-4 mm	Achilles, talar dome
2	Sag STIR / T2 fat-sat	sagittal	STIR	3-4 mm	Marrow edema, OCD, plantar fascia
3	Ax T1 or PD	axial	T1/PD	3-4 mm	Tendon/ligament anatomy
4	Ax T2 fat-sat	axial	T2 FS	3-4 mm	Tendons, ligaments, tenosynovitis
5	Cor T1 or PD	coronal	T1/PD	3-4 mm	Ligaments, sinus tarsi
6	Cor T2 fat-sat	coronal	T2 FS	3-4 mm	Osteochondral lesions, edema

Key points

Axial images best for ligaments and tendons; assess ATFL/CFL and posterior tibial/peroneal tendons.
Sagittal/coronal fluid-sensitive sequences detect osteochondral lesions of the talar dome.
For forefoot/midfoot or plantar fascia, recenter FOV on foot.
Add contrast for infection/osteomyelitis (especially diabetic foot) or tumor.

References

• ACR-SSR Practice Parameter for MRI of the Ankle and Hindfoot
• Radiopaedia: Ankle MRI protocol link
• ACR Appropriateness Criteria: Chronic Ankle Pain

Source: Researched — verify against your institution

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Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.