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Magnetic Resonance Evaluation of the Ankle With Persistent Pain or Instability Following Inversion Injury

Inversion injury of the ankle has been reported to be the most common sports-related injury. If the initial radiographs fail to demonstrate an osseous abnormality, management usually is conservative. Full recovery is expected following conservative treatment; a small percentage of patients, however, experience persistent ankle pain or instability. A wide array of injuries can be responsible for these refractory symptoms. Magnetic resonance imaging accurately depicts each of these injuries and differentiates among them, and it is a useful examination in directing appropriate therapy. Four broad categories of injuries are discussed in this article: injuries of the ligaments; injuries to the tendons; injuries to osseous structures and articular surfaces; and miscellaneous injuries, including impingement syndromes, sinus tarsi syndrome, and ganglion formation.