American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of imaging study may be useful in diagnosing conditions related to the heel?

1. X-ray

2. CT scan

3. Ultrasound

4. MRI

The correct answer is: MRI

Magnetic Resonance Imaging (MRI) is highly effective for diagnosing conditions related to the heel due to its superior capability to visualize soft tissues, including ligaments, tendons, and cartilage. Many heel-related conditions, such as plantar fasciitis, Achilles tendinopathy, and other soft tissue injuries, can be better assessed with MRI, which provides detailed images without radiation exposure. In particular, MRI allows for the examination of both the bony structures and the surrounding soft tissues, making it valuable for detecting inflammation, tears, or other pathological changes that may not be visible on other imaging modalities. This is particularly important for understanding complex conditions that could contribute to heel pain. In contrast, while X-rays can provide valuable information about bone structure and are effective for identifying fractures or bony abnormalities, they do not adequately assess soft tissue conditions. A CT scan offers a detailed look at bone details and is useful in evaluating complex fractures but is less effective than MRI for soft tissue evaluation. Ultrasound can be helpful in certain cases, as it is dynamic and can assess soft tissue structures and blood flow, but it generally has limited penetration and does not provide the same comprehensive view as MRI for deep or complex structures of the heel. Therefore, MRI stands out as the