When X-rays don’t reveal the cause of your foot or ankle pain, or when a more detailed picture of soft tissue structures is needed, MRI (magnetic resonance imaging) is the gold-standard diagnostic tool. At Balance Foot & Ankle, Dr. Tom Biernacki orders foot and ankle MRI when the diagnosis requires detailed soft tissue, cartilage, or bone marrow evaluation — and takes time to explain what the results mean in practical terms for your treatment.
What Does MRI Show in the Foot and Ankle?
MRI excels at visualizing structures that X-ray cannot see: tendons (Achilles tendon tears, posterior tibial tendon rupture, peroneal tears); ligaments (Lisfranc ligament, lateral ankle ligaments, spring ligament); cartilage (osteochondral lesions of the talus, first MTP joint cartilage loss); bone marrow (stress fractures, avascular necrosis, infection); soft tissue masses (ganglion cysts, lipomas, soft tissue tumors); nerve pathology (Morton’s neuroma, tarsal tunnel syndrome); and plantar fascia (tears, thickening, insertional changes).
When Does Dr. Biernacki Order an MRI?
Common indications for foot and ankle MRI at Balance Foot & Ankle include: suspected osteochondral lesion (ankle cartilage damage); possible Achilles tendon partial or complete tear; evaluation of tendon integrity after failed conservative treatment; suspected Lisfranc ligament injury with equivocal X-rays; chronic ankle pain with negative X-rays; suspected stress fracture with negative plain X-rays; soft tissue mass evaluation; suspected avascular necrosis (Köhler disease, sesamoid AVN); and evaluation before ankle replacement or complex reconstructive surgery.
What to Expect During a Foot/Ankle MRI
No radiation — Unlike X-ray and CT scan, MRI uses no ionizing radiation. It uses magnetic fields and radio waves to generate detailed images. It is safe for pregnant women (after first trimester, with physician approval) and children. Patients with certain metal implants (pacemakers, some cochlear implants) may not be able to have MRI — inform the facility and Dr. Biernacki of any implants.
Duration: A foot and ankle MRI typically takes 30–60 minutes. You’ll lie on a table with your foot positioned in the MRI bore. The machine makes loud knocking and buzzing sounds — earplugs or headphones are provided. Remaining still is important for image quality.
Weight-bearing vs. non-weight-bearing MRI: Standard MRI is performed lying down (non-weight-bearing). Some facilities offer upright or weight-bearing MRI, which is valuable for evaluating flatfoot, Lisfranc injuries, and other conditions where pathology is only visible under load. Dr. Biernacki requests the appropriate imaging protocol for your condition.
With or without contrast: Most foot and ankle MRIs are performed without gadolinium contrast. Contrast is added when evaluating soft tissue tumors, infection/osteomyelitis, or certain vascular conditions.
Understanding Your MRI Results
MRI reports use medical terminology that can be confusing. Dr. Biernacki reviews your MRI images directly (not just the radiology report) and explains the findings in clear, practical terms — what the abnormality is, how severe it is, and how it changes your treatment plan. A positive or negative MRI finding must always be interpreted in the context of your clinical symptoms and examination.
Getting Your Foot/Ankle MRI in Michigan
Dr. Biernacki orders MRIs at accredited imaging centers throughout southeast Michigan — many with same-week availability. Most insurance plans cover foot and ankle MRI when medically indicated with appropriate documentation. Call (734) 479-6200 to schedule an evaluation that may include MRI ordering at our southeast Michigan offices.
Frequently Asked Questions
Is a foot MRI better than a CT scan?
For most soft tissue foot and ankle problems (tendons, ligaments, cartilage, nerves), MRI provides superior detail. CT scan is better for complex bone fractures, coalition evaluation, and pre-surgical planning for bony deformities — it shows bone architecture more clearly. For suspected osteomyelitis (bone infection), both MRI and nuclear medicine bone scan are used complementarily. Dr. Biernacki orders the most appropriate imaging for your specific clinical question.
Can I have a foot MRI with a metal implant?
Many metal implants are MRI-compatible — titanium screws and plates used in most foot and ankle surgery are generally MRI safe. Pacemakers, certain cochlear implants, some older aneurysm clips, and metallic fragments near critical structures are potential contraindications. Always inform the MRI facility of all implants. The facility will contact the implant manufacturer to verify MRI compatibility before scanning.
Does insurance cover a foot and ankle MRI?
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Most insurance plans cover foot and ankle MRI when medically necessary — i.e., when the clinical situation requires soft tissue detail that X-ray cannot provide. Prior authorization is often required. Dr. Biernacki’s office submits the clinical documentation needed to obtain authorization. Patient cost after insurance varies by plan — typically $100–$400 depending on deductible status and in-network facility use.
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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
- Hallux Valgus (Bunions): Evaluation and Management (PubMed)
- Bunions (Mayo Clinic)