Imaging of the foot and ankle: Summary and update

Purpose of review: The purpose of this review is to highlight recent advances in foot and ankle imaging including computed tomography, magnetic resonance imaging, magnetic resonance angiography, nuclear medicine, and navigational systems. Recent findings: Advances in technology have improved the ability to visualize and conceptualize abnormalities through three-dimensional presentation of data, most notably when applied to helical multidetector computerized tomography. These advances have made possible submillimeter image resolution, multiplanar image reconstruction, improved visualization of metallic hardware, high-quality angiographic studies, and precise physical three-dimensional modeling for the surgeon. Increased magnet strength has resulted in faster, higher resolution musculoskeletal magnetic resonance imaging. Image quality in open magnetic resonance imaging systems has improved, and some of these units offer the possibility of weight-bearing foot and ankle imaging. Developments in the field of nuclear medicine with new radiotracers may lead to techniques for imaging of synovial abnormalities and inflammatory arthropathy. Exciting advances in computer-assisted surgery are being made that may significantly shorten operating time, reduce radiation exposure to the surgeon and the patient, and improve the accuracy of hardware placement. Summary: The orthopedist of today must understand these myriad new technologic advances, including their pitfalls, to most efficiently apply them for maximum patient benefit.