MRI of the ankle

definition

With the help of imaging procedures, different diseases and injuries in the ankle joint can be distinguished from one another. Ankle injuries are common sports injuries. Severe overstretching of the ligaments when "twisting" (Supination trauma) leads to an injury to the ligamentous apparatus.
An accurate diagnosis of the affected ligaments without imaging is usually difficult. Magnetic resonance tomography (MRT) is therefore used, which, compared to other imaging methods (X-ray, CT), shows the ligaments, cartilage and other soft tissue structures better.

Read more on this topic at: Ligament stretch at the ankle

In addition, with the help of an MRI scan, signs of wear and tear in the cartilage area and inflammatory changes in the area of ​​the joints can be identified and differentiated. Tumor-like lesions of the soft tissues and bones can also be assessed.

Indications

The MRI stands out in comparison to other imaging procedures by a particularly high soft tissue contrast out. This means that above all structures of the Connective tissue (e.g. Tapes, Cartilage), the muscles and the adipose tissue are clearly delineated.

That is why the MRI first choice in the diagnosis of Torn ligaments in the ankle area, at Inflammation and for cartilage and tendon injuries. Patients complain Ligament and muscle tendon injuries often over in the ankle strong pain in the area of ​​the foot (at rest or when running) or the ankle, about a Feeling of instability or one Restriction of movement. Also a strong one swelling in the area of ​​the ankle is possible.

Inflammation in the area of ​​the joints occurs in diseases of the rheumatoid form circle (i.a. Rheumatoid arthritis). The joints are of their own immune system attacked, which manifests itself in pain, swelling and limited mobility of the patient. Signs of wear in the field of Cartilage surfaces of the joints occur more frequently in old age or under heavy strain. These are also noticeable through pain and limited mobility of the foot.

Torn ligament

One differentiates between the ankle joint two different joints: the upper ankle and the lower ankle. Injuries to the ligamentous apparatus occur most frequently in the area of ​​the Outer bands of the upper ankle. It often comes through a lateral twisting of the foot to a strong Overstretching of the outer ligaments with the risk of cracking.
It is about a classic sports injurythat piled at Soccer, Handball and tennis occurs. Do this first strong pain in the area of ​​the ankle (stabbing, local), by a swelling to be accompanied. As the disease progresses, these pains increasingly radiate to the feet and legs.

examination

preparation

Before examining with the MRI should be the patient remove all metallic objects and clothing. There are usually changing rooms available in which (valuables) items can be safely stored. In addition, the doctor about possible Implants, Tattoos and other (non-removable) jewelery can be informed in a prior meeting. Depending on the implant, its size and location, MRI imaging may not be possible for the patient.

While imaging the ankle, the patient should No shoes wear. Wearing socks and trousers (without zippers, buttons, etc.) is usually not a problem. Depending on the practice or clinic, the patient is provided with clothing (including T-shirt, surgical shirt, mesh pants).

procedure

After depositing all metallic objects and items of clothing, the one to be examined Provide ankle with a coil. This encloses the ankle and serves the Registration of radio wavesthat are critical to imaging. The patient is then placed feet first in the MRI tube pushed. Usually, to examine the ankle, it is sufficient that the patient is pushed into the tube up to about the level of the thigh. The upper body and head are located outside the tube in this case. over Claustrophobia (claustrophobia) the doctor should be informed prior to the examination.

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The examination of the ankle does not take longer than, depending on the question 20 to 30 minutes. During this period, the patient should be as possible dont movein order to be able to guarantee good image quality. For distraction and reassurance, the patient is given headphonewhich are intended to distract him from the loud noise of the MRI machine, among other things. Also the administration of one Sedative is possible.

Duration

The examination of the ankle usually takes no longer than 20 to 30 minutes. The duration is depending on the question (Injury, inflammation, cartilage wear), the required position and the image quality. The quality of the images depends, among other things, on how steadily the affected foot is held during the examination. Movements of the patient can lead to blurred images, which is why a new exposure has to be made.

When administering a Contrast agent while the exam is scheduled, it will take a little more time.

After the imaging is performed, an Debriefing with a doctor about the new knowledge gained through the investigation.

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costs

The costs for an MRI examination are based on Cash patients after the uniform Evaluation standard (EBM) and at Private patients after Fee schedule for doctors (GOÄ). If an MRT examination is medically necessary, the costs will be paid to patients with statutory health insurance covered by the health insurance.
When imaging one or more joints or sections of extremities without medical need (Self-payers, private patients) the price is included 251,80€ (As of March 2017). In the case of private patients, the attending physician can provide an examination if the difficulty and duration of the examination are average 1.8 times the billing rate billing (high difficulty and duration: 2.3 times the billing rate). Also the administration of one Contrast agent costs the private patient additionally.

With or without contrast agent

Of the large part who finds MRI scans of the ankle without the administration of Contrast media instead of. Depending on the question or if the results are unclear, the application of contrast medium can be carried out via a vein be indicated during the examination.

Contrast media are used better representation perfused sections. Most commonly used as a contrast agent Gadolinium chelate causes surrounding atomic nuclei to return to their original state more quickly after being excited. This allows them to be more clearly delimited from one another in the MRT image (stronger black-and-white contrast).

The administration of contrast media is therefore mainly used in examinations of Inflammation or tumor-like structures used in the ankle area. Both inflammations and tumors are well supplied with blood, which leads to a strong accumulation of contrast medium.

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