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
51-year-old man complaining of Achilles pain for 2 weeks with no inciting event
Findings

SKELETAL/BONES:
Prominent/dysplastic anterior calcaneal process with cortical irregularity and joint space loss at the calcaneonavicular articulation, consistent with a nonosseous calcaneonavicular coalition. Minor subcortical cystic change adjacent to the calcaneal aspect of the coalition. Nominal osteoedema surrounding the coalition.
Concomitant nonosseous talocalcaneal coalition of the middle facet (with joint space loss, cortical irregularity and prominence of the middle subtalar facet). Moderate surrounding stress related osteoedema and subcortical cystic change.
Ill-defined osteoedema surrounding an ill-defined linear area of low signal that contacts the cortex of the posterolateral calcaneus, consistent with a microtrabecular stress fracture.
Mild dorsal calcaneal enthesophyte formation with low-grade osteoedema and periostitis.
No further micro- or macro-trabecular fracture or stress fracture identified. No further pattern of reactive osteoedema. No aggressive osseous abnormality.

ARTICULATIONS:
Tibiotalar joint/talar dome: No osteochondral defect of the talar dome or tibial plafond.
Ankle mortise/syndesmosis: The ankle mortise is in anatomic alignment. No syndesmosis widening.
Chopart joint: Nonosseous Calcaneonavicular and talocalcaneal coalitions as described above. Moderate stress-related osteoedema and fibrocystic change surrounding the talocalcaneal coalition. Moderate posterior subtalar facet osteoarthrosis with osteophytosis and joint space loss.
Midfoot/hindfoot: No fracture or injury of the anterior calcaneal process. No prominent midfoot or hindfoot arthrosis.

LIGAMENTS:
High ankle: Intact.
Low ankle: Intact. Small chronic intrasubstance partial-thickness cystic tear distal ATFL.
Subtalar/Chopart: Intact.

TENDONS:
Intact. Mild peritendinous high-signal edema superficial to the distal Achilles insertion, consistent with insertional enthesitis.

GENERAL:
Sinus tarsi: Unremarkable.
Muscles: No traumatic muscle injury. No volumetric muscle atrophy.
Soft tissue: Unremarkable.
Plantar fascia: Intact.
Neurovascular complex/tarsal tunnel: Unremarkable. No evidence of entrapment neuropathy.
Intra-articular/loose bodies: None.

Impressions
1. Nonosseous talocalcaneal coalition (involving middle facet). Moderate surrounding reactive osteoedema and subcortical degenerative cystic change.
2. Nonosseous calcaneonavicular coalition. Nominal surrounding osteoedema and subcortical cystic change.
3. Microtrabecular stress fracture posterolateral calcaneus (likely due to altered biomechanics of weight-bearing related to the above coalitions).
4. Mild insertional Achilles enthesitis.


Case

Fibrous calcaneonavicular and talocalcaneal coalition