Normal X-rays Don’t Always Mean a Normal Ankle

Ankle X-rays are excellent for detecting fractures, but many ankle problems involve ligaments, tendons, cartilage, or subtle bone injury, which X-rays cannot show. When pain persists, MRI is often the investigation that provides clarity.

Below are the most common situations where patients in Singapore proceed to an ankle MRI despite normal X-ray findings.

1. Ankle Pain That Persists Beyond a Few Weeks

If ankle pain:

• Lasts more than 4–6 weeks

• Does not steadily improve

• Affects walking or daily activity

MRI is commonly used to assess ligament, tendon, or cartilage injury.

2. Ankle Pain After a Sprain That Never Fully Recovered

Even mild sprains can involve:

• Partial ligament tears

• Tendon irritation

• Joint surface injury

MRI helps determine why recovery has stalled.

3. Recurrent Ankle Swelling With Normal X-rays

Swelling without a fracture may point to:

• Joint inflammation

• Cartilage damage

• Tendon irritation

MRI visualises fluid, synovitis, and internal joint pathology.

4. Ankle Instability or “Giving Way”

A feeling that the ankle:

• Buckles

• Feels unreliable on uneven ground

often indicates ligament injury, which MRI can evaluate accurately.

5. Pain After Sports or Sudden Twisting Movements

Sports-related ankle pain commonly involves:

• Ligament tears

• Tendon strain

• Osteochondral (cartilage + bone) injury

MRI helps identify the exact structure involved.

6. Ankle Pain Not Improving Despite Physiotherapy

If physiotherapy:

• Provides only temporary relief

• Does not restore confidence in the ankle

MRI helps explain why progress has plateaued, avoiding prolonged trial-and-error care.

7. Pain That Affects Work, Exercise, or Daily Mobility

When ankle pain:

• Limits standing or walking

• Affects job performance or exercise

MRI is often used to identify structural causes that need targeted management.

8. When Treatment Decisions Depend on Knowing the Exact Cause

MRI is commonly required before:

• Targeted non-invasive treatments

• Specialist referral

• Return-to-sport or activity planning

Clear imaging helps avoid delays, unnecessary procedures, and wasted costs.

How Long Does It Take to Get an Ankle MRI in Singapore?

• Public hospitals:
  Non-urgent outpatient ankle MRI appointments may involve waiting weeks or more, depending on demand.

• Private or clinic-based options:
  MRI scans are usually arranged much faster.

At The Pain Relief Clinic, ankle MRI scans can typically be arranged within one working day, subject to assessment.

How Much Does an Ankle MRI Cost?

• Public hospitals:
  Subsidised and lower out-of-pocket cost, but longer waiting times.

• Private hospitals / imaging centres:
  Higher and often variable pricing.

• The Pain Relief Clinic:

  • Clear upfront pricing, typically under S$1,000 for common outpatient ankle MRI scans

  • Costs explained before proceeding, reducing uncertainty

Do You Need to Travel to Another Location for the MRI?

Many care pathways require:

• Seeing a doctor at one clinic

• Travelling to a separate imaging centre

• Returning later for review

At The Pain Relief Clinic:

• MRI coordination is handled within the same clinic system

• No off-site imaging travel

• Faster review and smoother care flow

Payment Options to Know About

Patients at The Pain Relief Clinic may access:

• Medisave usage (subject to outpatient diagnostic limits)

• Insurance claim support (corporate and personal plans, subject to insurer rules)

• Cashless arrangements where applicable

• Interest-free instalment plans

• Cash and card payments

Quick Comparison

Final Takeaway

Ankle pain with a normal X-ray is extremely common, especially after sprains or sports injuries. MRI often provides the missing clarity needed to recover properly and avoid ongoing instability.

For patients who want:

• Faster answers

• Transparent pricing

• Minimal logistical hassle

• Flexible payment options

The Pain Relief Clinic offers a practical MRI pathway tailored to real-world needs in Singapore.

FAQ: MRI for Ankle Pain With Normal X-rays

What does it mean to have ankle pain with a normal X-ray?

This means ankle pain persists even though X-rays do not show fractures or obvious bone injury. X-rays mainly assess bones, but many ankle problems involve ligaments, tendons, cartilage, or soft tissues, which are not visible on X-ray.

If my ankle X-ray is normal, does that mean nothing is wrong?

Not necessarily. A normal X-ray does not rule out:

• Ligament sprains or tears

• Tendon injuries (e.g. Achilles, peroneal tendons)

• Cartilage or joint surface damage

• Bone marrow bruising or stress injury

• Sinus tarsi or soft-tissue inflammation

MRI is often needed to identify these causes.

When should an MRI be considered for ankle pain?

An MRI is commonly considered when:

• Ankle pain persists beyond a few weeks

• Pain keeps recurring after initial improvement

• There is swelling, instability, or giving way

• Pain affects walking, work, or sports

• Physiotherapy or rest has not resolved symptoms

• X-rays do not explain ongoing pain

What can an MRI show that X-rays cannot?

MRI provides detailed images of:

• Ankle ligaments (ATFL, CFL, deltoid ligament)

• Tendons and tendon sheaths

• Cartilage and joint surfaces

• Bone marrow stress or bruising

• Soft-tissue inflammation and fluid

This helps pinpoint the true source of ankle pain.

Is MRI especially useful after an ankle sprain?

Yes. MRI is particularly helpful when:

• Pain persists after an ankle sprain

• The ankle feels unstable

• Swelling does not settle

• There is difficulty returning to sports or exercise

MRI helps assess whether there is ligament damage, cartilage injury, or tendon involvement.

How long does it take to get an ankle MRI in Singapore?

Timing depends on the care pathway:

• Public hospitals:
  Non-urgent outpatient ankle MRI scans may involve waiting weeks or more, depending on demand.

• Private or clinic-based options:
  MRI scans are typically arranged much faster.

At The Pain Relief Clinic, ankle MRI scans can usually be arranged within one working day, subject to clinical assessment.

How much does an ankle MRI cost in Singapore?

Costs vary by provider and scan details:

• Public hospitals:
  Lower out-of-pocket cost with subsidies, but longer waiting times.

• Private hospitals / imaging centres:
  Higher and often variable pricing.

• The Pain Relief Clinic:

  • Clear upfront pricing, typically under S$1,000 for common outpatient ankle MRI scans

  • Costs explained before proceeding, reducing financial uncertainty

Do I need to go to a separate imaging centre for the MRI?

In many pathways, yes. Patients often need to:

• See a doctor at one location

• Travel to a separate imaging centre

• Return later for review

At The Pain Relief Clinic:

• MRI coordination is handled within the same clinic system

• No off-site imaging travel

• Faster review and smoother coordination

Can Medisave be used for ankle MRI scans?

Yes. Medisave can be used for outpatient MRI scans, subject to prevailing outpatient diagnostic limits.

Patients can clarify:

• Medisave eligibility

• Expected out-of-pocket cost
  before proceeding.

Are insurance claims or instalment options available?

Depending on coverage, patients at The Pain Relief Clinic may access:

• Insurance claim support (corporate and personal plans, subject to insurer rules)

• Cashless arrangements where applicable

• Interest-free instalment plans

• Cash and card payments

This flexibility is helpful when ankle pain limits mobility or work.

What happens after the MRI?

After imaging:

• Findings are reviewed alongside symptoms and examination

• The cause of ankle pain is explained clearly

• Next steps may include targeted conservative care, monitoring, or referral if needed

Accurate imaging helps avoid unnecessary delays or ineffective treatment.

Key Takeaway

Ankle pain with a normal X-ray is common and often involves ligament, tendon, or cartilage injury. MRI frequently provides the clarity needed to guide recovery.

In Singapore:

• Public hospitals offer subsidised scans but may involve waiting weeks or more

• Private hospitals provide faster access with variable pricing

• The Pain Relief Clinic offers a practical option with:

  • Clear upfront pricing under S$1,000

  • Fast MRI arrangement

  • No off-site imaging

  • Flexible payment options, including Medisave, insurance, cashless and instalments