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
50-year-old woman with a history of previous left plantar fasciotomy and nerve repair, now complaining of sharp pain in the same foot.

Findings
Skeletal/osseous and articulations:
Mild 1st metatarsophalangeal joint arthrosis, with associated joint space narrowing. No substantial spurring or subchondral fibrovascular reaction.

Mild to moderate degenerative arthrosis of the lateral sesamoid and to a lesser degree medial sesamoid. Lateral sesamoid demonstrates bipartite configuration.

Incidental note is made of a non-shouldered medial talar dome osteochondral lesion/defect measuring 5 x 6 mm. No displaced intra-articular fragment identified.

No substantial arthropathic change involving the visualized midfoot or 2nd to 5th metatarsophalangeal joints.

No micro- or macro-trabecular fracture. No stress related osteoedema. No stress fracture.

Incidental type 1 os navicularis/os tibialis externum. No adjacent posterior tibial tendinopathy.
Lisfranc joint:
Intact.

Tendons:
Intact and unremarkable.

Ligaments:
Intact.

Plantar plates:
Intact.

Soft tissues:
See below.

Other:
Status post previous medial cord plantar fasciotomy and tarsal tunnel surgery with nerve repair. Partially imaged nodular low signal fibrous scar tissue along the flexor retinaculum and throughout the tarsal tunnel, measuring approximately 1.8 x 1.1 cm.  Fibrous pseudomass abuts the adjacent tibial nerve and tibial nerve bifurcation within the tarsal tunnel. Fibrous pseudomass causes nerve compression within the tarsal tunnel. Mild thickening and edema of the plantar nerves within the tarsal tunnel.

Myoedema and mild-to-moderate atrophy of the quadratus plantae muscle, suggesting active lateral plantar nerve entrapment with function denervation.

Impressions
Tarsal tunnel syndrome with the following:
1. Postsurgical fibrous pseudomass involving the flexor retinaculum and tarsal tunnel, contributing to tibial and calcaneal nerve entrapment/impingement.
2. Muscle edema and atrophy of the quadratus plantae muscle, consistent with active impingement (Baxter neuropathy/forme fruste tarsal tunnel syndrome).
3. Incidental small osteochondral lesion of the medial talar dome, lateral sesamoid arthrosis, and mild 1st metatarsophalangeal joint arthrosis.


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