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British Journal of Radiology (2004) 77, 532-537
© 2004 British Institute of Radiology
doi: 10.1259/bjr/60447506
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MRI features of foot and ankle injuries in ballet dancers

J C Hillier, FRCR1, K Peace, FRCR1, A Hulme, FRCS2 and J C Healy, FRCR1

Departments of 1 Radiology and 2 Orthopaedics, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK



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  		Figure 1. 17-year-old male ballet dancer. (a) Sagittal spin echo T1 weighted MR (TR/TE, 722/20) image demonstrating an os trigonum posterior to the talus, between the posterior plafond of the tibia and the calcanium. Excess soft tissue (arrow) indicating a synovitis is seen in this interval. (b) Sagittal short tau inversion recovery (TR/TE/TI, 4655/30/130) demonstrates high signal within the os trigonum and the talus (arrows).

 


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  		Figure 2. 16-year-old female ballet dancer. (a) Sagittal spin echo T1 weighted MR image (TR/TE, 722/20) shows an os trigonum with excess soft tissue being compressed between the calcaneum and the posterior plafond of the talus, in keeping with posterior ankle impingement syndrome. (b) Sagittal short tau inversion recovery (TR/TE/TI, 4655/30/130) shows the localized oedema in the os trigonum, adjacent talus and the soft tissues in keeping with posterior ankle impingement syndrome.

 


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  		Figure 3. 17-year-old female ballet dancer. Axial fast spin echo T2 weighted MR image (TR/TE, 4500/95) shows loss of clarity of the anterior talofibular ligament, together with soft tissue in the anterolateral gutter (arrow) in keeping with anterolateral impingement. The posterior talofibular ligament is intact.

 


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  		Figure 4. 21-year-old female ballet dancer. Axial fast spin echo T2 weighted MR image (TR/TE, 4500/95) shows high signal around flexor hallucis longus (arrow) in keeping with tenosynovitis. Note the tendon itself returns normal low signal.

 


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  		Figure 5. 18-year-old female ballet dancer. (a) Coronal spin echo T1 weighted MR image (TR/TE, 722/20) showing low signal in the medial sesamoid (arrow). (b) Coronal short tau inversion recovery MR image (TR/TE/TI, 4655/30/130) showing high signal within the medial sesamoid in keeping with sesamoiditis.

 


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  		Figure 6. 17-year-old female ballet dancer. (a) Sagittal spin echo T1 weighted MR image (TR/TE, 722/20) shows low T1 signal within the medial sesamoid. In addition there is a smooth break in the cortex of the sesamoid (arrow), in keeping with a bipartite sesamoid. (b) Sagittal short tau inversion recovery MR image (TR/TE/TI, 4655/30/130) shows high signal in the medial bipartite sesamoid (arrow) in keeping with sesamoiditis.

 


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  		Figure 7. 18-year-old female ballet dancer. (a) Sagittal spin echo T1 weighted MR image (TR/TE, 501/20) shows a low signal line (arrow) extending from the cortex of the second metatarsal into the metaphysis characteristic of a stress fracture. (b) Sagittal short tau inversion recovery MR image (TR/TE, 5640/30/130) shows marked marrow oedema and the stress fracture.

 


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  		Figure 8. 35-year-old female ballet dancer. Sagittal spin echo T1 weighted MR image (TR/TE, 501/20) shows a well defined low signal crescent in the talar dome. This does not involve the articular cartilage and is in keeping with an early osteochondral injury.

 


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  		Figure 9. 18-year-old male ballet dancer. Axial fast spin echo T2 weighted MR image (TR/TE, 4500/95) demonstrates the low signal anterior talofibular ligament (long arrow) extending from the anterior aspect of the fibula to the talus. The posterior talofibular ligament is seen as a striated structure (short arrow) extending from the inner surface of the distal fibula to the posterior aspect of the talus.

 


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  		Figure 10. 16-year-old male ballet dancer. Axial fast spin echo T2 weighted MR image (TR/TE, 4500/95) shows the calcaneofibular ligament (arrow) at its calcaneal insertion just deep to the peroneal ligaments.

 


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  		Figure 11. 18-year-old female ballet dancer. Axial fast spin echo T2 weighted MR image (TR/TE, 4500/95) shows a thickened anterior talofibular ligament (arrow) in keeping with a chronic partial tear.

 




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