60-year-old male with effusion, left ankle neurofibromatosis, unspecified. Evaluate cause of swelling, patient with neurofibromatosis and multiple invasive neurofibromas. There is a joint effusion within the subtalar joint and sinus tarsus which demonstrates low T1 signal, intermediate T2 signal with enhancement compatible with synovitis. There is fluid and thickened synovium within the tendon sheath of the posterior tibialis tendon compatible with tenosynovitis. There is thickening and stranding of the adjacent medial subcutaneous tissues compatible with inflammatory changes. The posterior tibialis muscle appears normal. The remaining tendons and muscles of the ankle appear normal. Within the anterior calcaneus there is an area which demonstrates low T1 signal and intermediate T2 signal with mild enhancement in a tubular configuration compatible with a vascular remnant, which is a normal variant and of no clinical significance. Otherwise the bone marrow signal appears normal.The ligaments of the ankle appear normal.
1. No findings to suggest neurofibromatosis in the left ankle.2. Synovitis of the subtalar joint and sinus tarsus.3. Tenosynovitis of the posterior tibialis tendon with adjacent inflammatory changes in the medial subcutaneous soft tissues.4. Normal variant vascular remnant within the calcaneus, of no clinical significance.