MRI Reading

Question 1

What is the magic angle effect?

Answer 1

If the structure is 50 degrees oriented to the planar film it will appear bright on T1. If the tendon is still bright on T2 it Is likely that there is pathology present, if it is black there is no pathology present.

Question 2

Which structures will always appear black on both T1 and T2?

Answer 2

Tendon, ligament, cortical bone, calcifications, flowing blood, and hemosiderin

Question 3

What stuctures are found under the fourth metatarsal and lateral ½ of the third met

Answer 3

Interossei

Question 4

Everything under the second metatarsal head will be…?

Answer 4

Oblique head of the adductor halluces

Question 5

Any small well circumscribed structure under the calcaneus that is most proximal in a sagitall view is …

Answer 5

always abductor digiti minimi

Question 6

When you see FDB and its proximal to the TMTJ it will never bee seen without the structure that lies atop of it =

Answer 6

QP

QP is carried with FDB when proximal to the TMTJ line.

Question 7

At the TMTJ joint line QP ends and the … begins.

Answer 7

oblique head of the adductor haluccis

Question 8

• There are three ligaments in the foot that are notoriously striated (circled under second met). They are,,,

Answer 8

short plantar, posterior talofibular, and the posterior tibial talar ligaments.

this is because these three ligaments strangely have a high content of fat. (Ligaments normally dark, but will see them striated in T1 due to high concentration of fat).

Question 9

• If you divide the calcaneus in half everything laterally underneath it is the

Answer 9

abductor digiti minimi.

Question 10

What you will find under the medial ½ of the calcaneus is … sitting atop … which sits atop…

Answer 10

1. QP (lots of fat)
2. FDB
3. plantarfascia.

Question 11

• You will not see … until you no longer can see calcaneus, might see the sustentaculum tali.

Answer 11

abductor halluces

Question 12

Regardless of the section, the structure that sits the closest to the FHL tendon will always be the….

Answer 12

tibial nerve, or it is a division between the medial and lateral plantar nerves.

Question 13

• On the lateral wall of the calcaneus, PB will always be …PL or more medial than PL depending on how lateral you are on the calcaneal wall.

Answer 13

Above or more medial to PL

Question 14

Which side of the peroneus brevis muscle does the tendon come off of when looking AP?

Answer 14

Lateral side

Question 15

Odds are if you are looking at a muscle behind the tibia it is likely…

Answer 15

FHL

Question 16

Which muscle is always found medially at the level of the ankle in an AP view?

Answer 16

The QP.

Question 17

Which extensor tendon is always seen from the lateral skin of the fifth to the bisection of the second met?

Answer 17

EDL

Question 18

Which extensor tendon can be observed from the medial aspect of the bisection of the second to the first metatarsal?

Answer 18

EHL

Question 19

When will you begin to see the anterior tibial tendon?

Answer 19

From the bisection of the first metatarsal to the medial skin.

Question 20

What is the only muscle on the lateral side of the fifth met plantarly/

Answer 20

Abductor digiti minimi

Question 21

When looking at the fifth met, which muscle is most medially under the met?

Answer 21

Flexor digiti minimi

Question 22

Which metatarsal is chosen as the forefoot divider and why?
What muscle is found laterally to the division?

What about from the bisection to the second met?

Answer 22

The third met because of the natural subcutaneous fat separation under the third metatarsal.
Lateral to this division is all the interossei.

From the bisection of the third met to the secon met it is all th oblique head of the adductor hallucis.

Question 23

What muscles are found under the first metatarsal in a coronal section?

Answer 23

This will be FHB riding over the top of FHL.

Question 24

The short flexors will always be… to the long flexors.

Answer 24

Inferior and lateral!

Question 25

Name the layers that a nail would hit passing under the mets in the forefoot?

Answer 25

Inserts central band plantar fasciae
Muscle FDB (QP wont be here because its past the TMTJ)

FDB tendon
FDL tendon
Oblique head

Question 26

What muscle comes off the medial side of the FDL tendons in the forefoot?

Answer 26

Lumbricals

Question 27

What is the most lateral extensor tendon to the fifth toe?

Answer 27

Fourth EDL (There are only four as the EHL is not part of the EDL)

Question 28

What is the first EDB tendon and where does it go?

Answer 28

Goes to the hallux!

It is just renamed as the EHL.

Question 29

Which interossei do we need to be worried about for the exam?

Answer 29

Unless it is the first or second dorsal interossei just lable the structure interossei.

Question 30

Where does the FHL sit before it gets between the sesamoids?

Answer 30

Before the FHL hits the sesamoids it typically sits with the lateral head of the FHB.

Question 31

What is the name of the structure that will be seen with a transverse section under the calcaneus on the medial aspect with tendons in it?

Answer 31

FDB

If it were the QP all of the FDB tendons would be in one bunch.