CT Scans for Foot and Ankle Injuries

eaturing Dr. Audrey Spielmann, MD, FRCPC

Duration: 2 minutes, 46 seconds

Ankle injuries are really common in sports.

One of the most common mechanisms for an ankle injury is an inversion type injury and patients can have fractures, or ligamentous, or tendonis injuries with that.

CT is excellent to look for bony injuries and we see this type of injury in many sports such as racquet sports, any kind of running sport such as soccer, football, rugby, less so with hockey players where the ankle is a little bit more contained within the skate.

And the CT scan is excellent to look for subtle bony injuries. The other thing that CT is really good for is to assess for any degenerative changes that might be present from repeated injuries, chronic injuries, or perhaps patients who are the so-called weekend warrior who have had injuries in the past or actually have some degenerative changes in their joints and they're wondering why they can't do the same activities that they used to be able to do. Tennis would be a great example for that.

So here we have a case where there is an ankle CT scan in an older patient, and I'm just going to highlight this image. With a CT scan we can see bone detail the best. Here we see a large bone spur arising from the talonavicular joint. This patient would have a hard time fitting ski boots I think.

There is also cystic change seen here in the bone. You can see these little dark areas and irregularity at the joint space, also within the sub taylor joint. So this patient has quite advanced degenerative change within her joint, which is going to be causing repeated and ongoing pain and may hinder her sports activities to a certain degree.

The other benefit of CT scan is that we can reconstruct the images in multiple planes. Here's a coronal image, vestigial image, and an axial image, all of the same area. And we use all three planes to identify the bony changes. And sometimes really subtle fractures can only be seen on one plane. Here's the three-dimensional image showing the bone spur at the talonavicular joint.

CT scan shows us bone detail to the best extent out of all of our imaging modalities and is complementary with MRI. If you have any questions regarding CT scan of the ankle, contact your family doctor, your sports medicine physician, or an imaging center.

Presenter: Dr. Audrey Spielmann, Radiologist, Vancouver, BC

Local Practitioners: Radiologist