Foot & Ankle MRI Fellowship Practice Cases

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		<div id="tve_flt" class="tve_flt tcb-style-wrap"><div id="tve_editor" class="tve_shortcode_editor tar-main-content"><div class="thrv_wrapper thrv_text_element">This course includes 25 essential cases a radiologist needs to master to confidently diagnose foot and ankle conditions on MRI.<a href="https://mrionline.com/remote-fellowships/" class="">Browse all Radiology Remote Fellowships</a><h2 class="" dir="ltr">Desired Outcomes</h2>Upon completion of this activity, participants should be better able to:<ul class=""><li dir="ltr">Interpret essential pathologies for foot/ankle MRI</li><li dir="ltr">Diagnose foot/ankle conditions for MRI&#160;</li></ul>Bibliography: Suggested reading resources and references can be found within each case discussion.<h2 dir="ltr" class="">Credit Information</h2>Accreditation StatementMRI Online is accredited by the Accreditation Council for Continuing Medical Education (ACCME)to provide continuing medical education for physicians.Credit Designation StatementMRI Online designates this Enduring activity for a maximum of 14.25&#160;AMA PRA Category 1 Credits&#8482;.Physicians should claim only the credit commensurate with the extent of their participation in the activity.This activity is valid for credit from November 6, 2023 to November 6, 2026.Content is reviewed and updated on an ongoing basis.CME Planning Committee&#160;Suresh K. Mukherji, MD, MBA, FACRProfessor of Radiology, University of IllinoisProfessor of Radiation Oncology, Robert Wood Johnson Medical School, Rutgers UniversityFaculty, Otolaryngology Head Neck Surgery, Michigan State UniversityNational Director of Head &amp; Neck RadiologyProScan ImagingStephen J. Pomeranz, MDChief Medical Officer and FounderProScan ImagingFounderMRI OnlineDavid M. Yousem, MBA, MDProfessor of RadiologyVice Chairman and Associate DeanJohns Hopkins UniversityDaniel Arnold, MBACEO and Co-FounderMRI OnlinePaul BohartSenior Content ManagerMRI OnlineJennifer A. Hall, MSDirector, FellowshipsMRI OnlineDeanna M. Heier, PhDVP, Educational Strategy and OperationsMRI OnlineDisclosure StatementsCME Planning CommitteeThe CME Planning Committee members have no relevant financial relationships to disclose.FacultyThe Faculty for this activity have no relevant financial relationships to disclose.Staff and Content reviewersAll MRI Online staff and reviewers involved in the development of content for this activity have norelevant financial relationships to disclose.Commercial SupportThere is no commercial support for this activity.Course content is peer-reviewed for content validity by persons that do not have conflicts of interest related tothe content and to verify the educational material is evidence-based, fair, balanced, and free from commercial bias.</div></div></div><div class="tcb_flag"></div>
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Stephen J Pomeranz

Jenny T Bencardino

Edward Smitaman

Gain confidence reading and reporting on Foot and Ankle MRI Cases with the Medality Fellowship Certificate Program. Practice using real-world, scrollable cases, earn CME, and receive a Fellowship Certificate™ upon completion!

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Course Evaluation

Post-Course Activities

Welcome to the Foot and Ankle MRI Fellowship Practice Cases course! In this course, you&rsquo;ll be presented with a series of worklists, comprised of 25 essential cases you must review to receive your Fellowship Certificate.

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Access Full Fellowship Certificate Program <a href="https://mrionline.com/proficiency/foot-and-ankle-mri-fellowship-certificate/" style="text-decoration:none">Here</a>&nbsp;

Foot and Ankle MRI Practice Cases

Patient History
4-year-old patient with no known injury complaining of right ankle pain and inability to bear weight.

Findings
SKELETAL/BONES:
Marked diffuse edema throughout the distal tibial chondral epiphysis with extensive surrounding soft tissue inflammation (loss of the normal apophyseal hyperintensity). Low-grade osteoedema through the distal tibial metaphysis. Diffuse intermediate-grade osteoedema throughout the talus, predominantly around the tibiotalar articulation.  Marked diffuse high signal tibiotalar capsulosynovial thickening associated with a complex effusion.

Low-grade osteoedema through the plantar calcaneus.

Preservation of the cortical outline (no cortical destruction/dehiscence). No subperiosteal fluid collection.

No micro- or macro-trabecular fracture.

ARTICULATIONS:
Tibiotalar joint/talar dome: Complex tibiotalar effusion with particulate debris. Extensive capsulosynovial thickening.

Ankle mortise/syndesmosis: The ankle mortise is in anatomic alignment. No syndesmotic widening.

Chopart joint: Unremarkable.

Midfoot/hindfoot: Unremarkable.

Lisfranc joint: The Lisfranc joint is intact, without fracture or joint space widening.

LIGAMENTS:
High ankle: Intact. Diffuse reactive edema extending along the interosseous membrane.

Low ankle: Intact.

Subtalar/Chopart: Intact.

TENDONS:
Reactive tenosynovial thickening involving the posterior tibial tendon and flexor digitorum longus at the level of the joint. No tenosynovial effusion.

GENERAL:
Sinus tarsi: Unremarkable.

Muscles: Diffuse muscle edema of the distal tibialis posterior.

Soft tissue: Extensive soft tissue swelling centered around the tibiotalar articulation.

Plantar fascia: Intact.

Neurovascular complex/tarsal tunnel: Unremarkable. No evidence of entrapment neuropathy.

Intra-articular/loose bodies: None.

Impressions
1. Acute or subacute inflammatory tibiotalar arthritis (favoring septic arthritis, or less likely JIA or juvenile idiopathic arthritis with a developing area of avascular necrosis involving the tibial epiphysis). Tibiotalar capsulitis with associated complex effusion containing particulate debris (possibly purulent). Regional myositis (tibialis posterior). No intraosseous, subperiosteal or soft tissue abscess.
2. Recommend joint aspiration and analysis.


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