About an Achilles tendon MRI scan
The Achilles tendon is the large, rope-like band of tissue that joins your calf muscles to the back of your heel bone. It lets you rise onto your toes and push off when you walk, run or jump, so it carries a lot of load and is a common site of pain and injury.
An MRI scan uses a strong magnetic field and radio waves, with no X-rays, to make detailed pictures of the tendon and the tissues around it. MRI is particularly good for soft tissues such as tendons and ligaments. It can show whether the tendon is thickened or inflamed, whether there is a partial or complete tear, and whether the heel bone or nearby fluid sacs (bursae) are involved. Left and right sides are scanned separately, so choose the side you need when you book.
What happens during the scan
You lie on your back or front on the scanner bed with your lower leg and foot in a special coil. Usually only your legs and lower body need to go into the scanner, so many people find this scan easier than a scan of the head or body. The scanner is loud, so you will wear ear plugs or headphones, and you need to keep your foot still while the pictures are taken. Contrast dye is not usually needed, but it is sometimes used after surgery or if infection is suspected.
What the scan can show
An Achilles tendon MRI can help to look at:
- Achilles tendinopathy, the most common Achilles problem, which causes pain, stiffness and thickening of the tendon
- partial tears, where MRI is more reliable than ultrasound
- complete rupture, including the size of the gap between the torn ends, which helps with planning treatment
- inflammation around the tendon (paratendinopathy)
- insertional problems where the tendon joins the heel bone, including bone marrow swelling and bursitis
- changes after surgery, such as healing, re-rupture or infection
- lumps such as ganglia, and inflammatory conditions that affect the tendon attachment
Sudden injury? If you felt a sudden pain like a kick to the back of the calf and now cannot push off or point your foot properly, you may have ruptured the tendon. Get urgent medical advice (for example from NHS 111 or an urgent treatment centre) rather than waiting for a scan.
Preparing for your scan
No special preparation is needed for an Achilles tendon MRI. You can eat and drink normally.
You can usually eat, drink and take your normal medicines as usual unless the scanning centre tells you otherwise. Wear loose, comfortable clothing without metal zips or buttons, and leave jewellery at home. You will be asked to remove metal items such as hair clips, hearing aids, coins and keys, and you may be asked to change into a gown.
Before the scan you will complete a safety questionnaire. Tell the team if you have a pacemaker, any metal implant, surgical clips or other device, if you have kidney problems or allergies, or if you are, or might be, pregnant or breastfeeding. If you feel anxious in enclosed spaces, let us know when you book. Some centres can offer a relaxant, and if you take one you will need someone to take you home and must not drive for 24 hours.
If you have been given a walking boot or cast, bring it with you. The radiographer will tell you whether it needs to come off for the scan.
Frequently asked questions
Is MRI or ultrasound better for the Achilles tendon?
Both are useful. Ultrasound is quick and works well for tendinopathy and complete ruptures. MRI gives a fuller picture, is better at finding partial tears and problems in the bone and surrounding tissue, and is preferred after surgery.
Will my whole body go into the scanner?
Usually not. For an Achilles scan you normally go into the scanner feet first and your head stays outside or near the opening, which many people find more comfortable.
Do I need to book the left or right side?
Yes. Each side is a separate scan. If you need both, book both sides together, as two or more areas booked together qualify for the lower clubbed price.
Do I need a referral?
You can tell us if you have a referral from your GP, physiotherapist or consultant and upload it when you book. If you do not have one, select “no referral” when you book and the scanning centre will confirm the next steps with you.
Sources
- Szaro P. et al. – MRI of the Achilles tendon: a comprehensive pictorial review, Part one (European Journal of Radiology Open, 2021)
- Cambridge University Hospitals NHS – Achilles tendon rupture
- NHS Lothian RefHelp – Achilles tendon problems
- RadiologyInfo.org – Musculoskeletal MRI
- NHS – MRI scan
The information on this page has been gathered from various sources and is provided for general information only. It is not medical advice. TOP MRI is not liable for the accuracy or completeness of this information. Please speak to your doctor or the scanning centre about your own situation.