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Arthroscopic intervention of the foot and ankle is used for a growing number of procedures. Magnetic resonance imaging (MRI) can be a helpful technique while detecting pathology before surgical intervention. A common use of MRI is detecting osteochondral lesion of the talus; however, other pathology can be detected including but not limited to symptomatic Os trigonum and subtalar osteochondral defects. An MRI sensitivity and specificity for detecting these pathologies vary. Correlating findings on MRI with arthroscopy is helpful in determining its accuracy and will be discussed in the following case examples.