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MRI scans are frequently used to evaluate the internal structures of the ankle (you can read more about MRI here). A variety of trends have increased the use of MRI in evaluating our joints - more sports activity, increase in obesity rates, diabetes, and we've remained much more active into our later years than previous generations.

If you've injured your ankle or have ankle pain, your doctor will probably first order an x-ray. After an x-ray, an MRI may be needed to evaluate the tendons, ligaments and bones of the ankle. On your doctor's order for the MRI you might see:

"r/o stress fracture" - this refers to a "hairline" fracture of a bone that is not seen on an x-ray.

"r/o ligament injury"- there are many tendons and ligaments which pass through the ankle area and can be injured or degenerate.

"r/o osteochondral defect" - this is a defect of the bone and cartilage that can cause chronic pain.

(FYI - "r/o" is short for "rule out")

An MRI of the ankle will evaluate:

Bones

An ankle MRI will include parts of the lower tibia, lower fibula and the ankle bones which include the talus, calcaneus and some of the forefooot bones. An ankle MRI can detect bone bruises, fractures, cysts, tumors, infection and dislocations. An MRI can also determine the extent of arthritis and assist in pre-operative planning.

Cartilage

Ankle MRIs are very good at looking at the cartilage. MRI can detect cartilage fraying (like frayed edges of jeans), fissuring (cracks, similar to a dry river bed), and defects (the cartilage is missing). Damaged cartilage can lead to chronic pain and arthritis.

Tendons and Ligaments

Your ankle has a complex set of tendons and ligaments that an MRI can evaluate. The Achilles tendon is the large tendon at the back of your ankle. This can develop internal tears and cause pain. Tendons along the sides of your ankle can also develop tears and cause pain and a flattened arch for example. Ligaments like the deltoid ligament help suport your ankle. Any of these tendons and ligaments can be injured and the injury may only be seen on MRI.

Soft Tissues

This refers to the muscles and tissues around your ankle. An ankle MRI scan will show parts of the lower leg and foot muscles. An MRI can detect muscle tears, strains, tumors and infection. It can also detect fluid collections in the joints.

Your Ankle MRI Scan

An ankle MRI generally takes about 30 minutes or so to complete. If you are going for one, wear loose comfortable clothing and remember to remove all metal (jewelry, phones, rings, etc) before going into the MRI scan room. If you're insured, you may need to have your test authorized (approved) by your insurance company first. If you're uninsured and need to look up prices and buy an MRI scan of the ankle, you can use our website. Click here to see MRI scan costs.

Have you had an Ankle MRI scan? What was it like? Please leave your comments below.

MRI scans are frequently used to evaluate the internal structures of the brain. Pituitary gland MRIs are used to discover tumors of the pituitary gland. FYI a pituitary MRI is also sometimes called a sella MRI.

In the picture to the right the pituary gland is the gray structure sitting in the white bone. You can see the thin stalk connecting it to the brain.

Your pituitary gland secretes many different kinds of hormones. Pituitary tumors can either destroy normal hormone secreting cells or create excessive hormones. Pituitary tumors can cause symptoms such as tiredness, headache, nipple discharge, excessive growth, and thirst. Some of the larger tumors can also press against nearby structures such as your optic nerves and affect your vision.

An MRI of the pituitary gland will look for:

Microadenoma - These are tiny (less than 10 mm in size) tumors that are usually suspected because they secrete a hormone such as prolactin for example. Prolactin causes milky nipple discharge.

Craniopharyngioma - These pituitary tumors are generally found in young children and cause symptoms related to their size. They press on the optic nerves causing vision symptoms and compress nearby brain and can cause hydrocephalus leading to headaches.

Cysts - Most pituitary cysts are asymptomatic and small. But some large cysts can act like tumors in that they press on nearby brain structures and cause symptoms such as headache.

Apoplexy - Some pituitary tumors can bleed and destroy much of the pituitary gland causing severe hormone imbalances. Or if the pituitary gland loses its blood supply it will result in a similar set of symptoms. This condition is called pituitary apoplexy and can be life threatening. The MRI will look for blood or tissue death in the pituitary gland.

An MRI of the pituitary gland (sella) will evaluate:

Pituitary gland

The pituitary gland is a pea sized structure in the middle of your brain just behind your eyes. It sits inside a bone cavity called the  sella dorsica. The gland is attached to the brain by a thin stalk called the infundibulum. 

Orbits

Although Pituitary MRIs are not tailored to look at the orbits, parts of the visual pathways are included as large pituitary tumors can compress the optic nerves (optic chiasm) and cause visual symptoms.

Bones

Brain matter

Parts of the white and gray matter of the brain are  seen. MRI can detect tumors, infection, bleeds, and stroke. Since some pituitary tumors grow and expand into the brain, the nearby brain structures are always included in the study.

Your Pituitary Gland MRI Scan

A pituitary MRI generally takes about 30 minutes or so to complete. If you are going for one, wear loose comfortable clothing and remember to remove all metal (jewelry, phones, rings, etc) before going into the MRI scan room. This test is nearly always done with IV MRI contrast.

If you're insured, you may need to have your test authorized (approved) by your insurance company first. If you're uninsured and need to look up prices and buy an MRI scan of the pituitary gland, you can use our website to look up MRI scan costs and then purchase with your credit card.

Have you had a Pituitary MRI scan? What was it like? Please leave your comments below.

MRI scans are frequently used to evaluate the internal structures of the brain and nearby structures. Orbit MRIs are used to discover tumors, infection and chronic diseases that affect the structures in and around the orbits.

Orbit MRIs are nearly always done as a with and without contrast exam. That is, first the MRI is done without the dye injection and then images are taken after the dye has been administered by IV. Below are a few common conditions that Orbit MRIs can evaluate.

Tumor - Tumors can be primary (from the eye) or secondary (from other sites, eg melanoma). These typically present with eye pain, double vision, or are picked up during an eye exam.

Infection - Orbit infections present with eye pain, double vision, watery eyes and swelling of the tissues around the eyes. Some inflammatory conditions affect the eye itself whereas others may affect the lacrimal gland (makes tears) or the fat that surrounds the eyeball. Orbit MRIs are also very good at evaluating the nearby bones for infection (called osteomyelitis).

Optic Neuropathy - The optic nerve carries light signals from the retina (back of the eye) to the brain. Think of it as a cable filled with signals. If this is damaged or deteriorates, an Orbit MRI can pick up changes to the nerve. Damage to the optic nerve can appear as either thickening or thinning of the nerve.

Other conditions - Orbit MRIs can pick up papilledema (swelling head of the optic nerve), enlarged eye muscles (seen in thryoid conditions), infection or tumors of the lacrimal gland and enlargement of vessels that supply and drain the eye area.

An MRI of the Orbits will also partially evaluate:

Sinuses

An Orbit MRI will include parts of the sinuses. Though not used to primarily look for sinus disease, an MRI can see thickening of the sinus tissue (mucosa) or fluid in the sinuses.

Bones

Brain matter

The white and gray matter of the brain are also partially seen. MRI can detect tumors, infection, bleeds, stroke and congenital defects. The pituitary gland and upper brainstem are also evaluated.

Your Orbit MRI Scan

An Orbit MRI generally takes about 30-45 minutes or so to complete. If you are going for one, wear loose comfortable clothing and remember to remove all metal (jewelry, phones, rings, etc) before going into the MRI scan room. This test is nearly always done with IV MRI contrast.

If you're insured, you may need to have your test authorized (approved) by your insurance company first. If you're uninsured and need to look up prices and buy an MRI scan of the orbit, you can use our website to look up MRI scan costs and then purchase with your credit card.

Have you had an Orbit MRI scan? What was it like? Please leave your comments below.

We have some very exciting news to share with you. We have made changes to our site and have expanded how we feature real prices and costs of MRI scans, CT scans, Ultrasounds, PET scans and more.

This will give healthcare consumers an online tool to look up out of pocket costs, self pay prices, learn more about Radiology tests, research local imaging centers, get office hours...and buy the test. That's right, you'll be able to buy your doctor ordered MRI scan directly on our site.  You can see MRI scan, CT scan, Ultrasound prices and more here.

You'll see some changes here at the blog and then across the rest of the site in the upcoming weeks. So please pardon our mess (and the bugs)!

Update --

We're now listing Radiology costs for over 400 outpatient centers in California and New York. Check out prices and more here.

A lot of patients are confused as to who actually interprets their MRI scan (or CT, Ultrasound, X-ray, Mammogram, etc). Many mistakenly assume it's the technologist who performs the exam. Some doctors own their own x-ray equipment and review scans with their patients. But if you've had your test done at a hospital or outpatient Radiology facility it will be read by a Radiologist.

What is a Radiologist?

A Radiologist is a doctor (MD) that has specialized in interpreting Radiology tests such as MRI, CT, Ultrasound, Mammogram, DEXA, PET, X-ray, and Nuclear Medicine. Some Radiologists (interventional Radiologists) also do procedures like angiograms and biopsies. It takes 6+ years after medical school to be trained and certified. Like many specialists Radiologists are board certified, in their case by the American Board of Radiology. 

What does a Radiologist do with my MRI scan?

A Radiologist will read your MRI scan images either on film or on a computer screen. They look for abnormal findings and then dictate a report. The report goes to your doctor. If there is anything highly unusual the Radiologist will frequently call your doctor and inform him or her before the report is sent to their office.

Where is the Radiologist?

Usually right in the facility where you are getting your test! They read scans in "reading rooms" that have computers and special high end monitors. In some hospitals or outpatient facilities they place IVs for contrast injections. If they are interventional Radiologists, you'll see them during the procedure in the "angio" or "specials" procedure room.

Why don't I get results directly from the Radiologist?

The Radiologist may not be aware of all of the issues of your medical care. Although they read MRI scans, which are integral to planning your treatment, detailed discussion and options are handled by your primary care doctor or your specialist.

Is there anything else you'd like to learn about Radiologists? Please leave your comments below.

An MRI is high-tech medical imaging test that can help your doctor diagnose many different types of disease.  You can read more about MRI scans here.

When your doctor decides to send you for an MRI he or she will fill out a prescription or a Radiology referral form. The form will usually have your name, your symptoms, the doctor's signature, and the type of test being ordered.

The MRI test your doctor orders usually matches the body part where you are having symptoms. For example, if you have knee pain, your doctor will order an MRI of the Knee. Your doctor or the Radiologist interpreting the scan may recommend that the test be done with contrast (aka dye). 

MRI Contrast Indications

Roughly, about 20% of MRIs are ordered with contrast. MRI contrast is used in specific circumstances and  enhances the MRI scan images. Here are some common reasons why contrast is given:

• History of tumor, cancer, or surgery
• Looking for infection, inflammation, or cancer
  
• Evaluating blood vessels
  
• Investigate a finding on the pre-contrast part of the scan

MRI Contrast Side Effects

Though MRI contrast (gadolinium) is safer than the CT contrast, there are still some risks associated with the injection. The most common side effects include:

• Allergic reaction
• Flushing/redness
• Hives
• Blood clots
• Dizziness
• Shortness of breath
  

The Contrast Injection

The injection is usually given after some "pre-contrast" MRI scans have been done. The techologist or Radiologist wil come into the MRI scan room and move the table out of the MRI machine. He or she will then place a tourniquet around your arm or hand. Using a small butterfly needle or an IV, they'll inject about 10-20 milliters of dye into your vein. The needle is removed and you are placed back into the MRI machine for the rest of the scan.

Passing on the Contrast Injection

As a patient, you have the right to be informed and decide how you receive medical treatment. If you are afraid of the injection or potential contrast side effects, you should discuss this with your doctor or the Radiologist at the facility and learn more about why the contrast is being given.

MRI machines use a magnetic field to create images of the inside of your body. As these magnets are very powerful, they will attract metallic objects. As part of the preparation and screening for an MRI scan, the Radiology staff at the clinic or hospital will ask you about metal in your body.

Orthopedic hardware such as spinal rods, joint replacements and plates for fractures are safe. Braces and dental fillings are safe as well. That is, they won't move or "fly out of your body." Keep in mind that the MRI will slightly heat these up and you may feel a warm or tingling sensation.

Metal does interefere with the quality of the scan, particulary if the body part being scanned is near or has these metallic objects in it. So if you have braces and a need a Brain MRI, image quality will suffer.

If you have a pacemaker or medication pump the MRI can interefere with its normal function. It is not safe to go into the MRI scan room if you have either or both of these. You should inform your doctor and the Radiology staff.

Newer brain aneurysm clips are safe to go into the MRI machine but you should check with your doctor. It helps to have the name and type of clip that was placed. You can give this information to the Radiology center and they will look up to see if your aneurysm clip is safe for MRI.

If you use an oxygen tank or are in a wheelchair, you should inform the Radiology staff in advance. These should not go into the scan room. The facilty will have metal free wheelchairs and extension tubing for your oxygen tank.

If you have worked with metal in the past you should inform your doctor and the Radiology facility. Tiny metal shavings may be in your eyes.  These shavings can move when exposed to an MRI machine's magnetic field, potentially damaging your vision. You will need an x-ray of your eyes (orbits) to look for metal before your MRI scan.

These will be damaged by the magnetic field of an MRI scanner:

• Cell phones
• iPods
• Credit cards
• Pacemakers
• Medication pumps
  

You should remove these items as they could fly into the MRI scanner and injure you or the technologist:

• Metal pens
• Paper/hair clips
• Jewelry, piercings
• Keys, belt buckles 
• Oxygen tank, wheelchair
• Transdermal medication skin patches (skin burns)

If you have the following you should not go into an MRI scan room:

• Cardiac pacemaker
• Medication pump
  
• Metal in eyes