Frequent ankle sprains TENDONS: Achilles tendon is unremarkable. Fluid is noted within the tendon sheath of the posterior tibialis tendon which may reflect mild tenosynovitis. Fluid is also noted within the tendon sheath of the flexor hallucis longus which could represent additional mild tenosynovitis or extension of fluid from the tibiotalar joint. A small amount of fluid is seen along the peroneal tendons which is of unlikely clinical significance.LIGAMENTS: The anterior talofibular ligament is not seen, presumably from prior tearing. Although the fibular attachment of the calcaneofibular ligament is indistinct, distally the ligament is visualized and we suspect that it is intact. The posterior talofibular ligament is perhaps slightly attenuated but otherwise appears intact. The distal tibiofibular syndesmotic complex is intact. There is loss of the normal fatty striations of the deep tibiotalar fibers of the deltoid ligament which may reflect prior sprain. The spring ligament appears intact.ARTICULAR SURFACES AND BONE: There is focal full-thickness articular cartilage loss along the talar dome laterally with mild edema in the underlying talus and additional mild articular cartilage degeneration along the talar dome posteromedially. There is a small tibiotalar joint effusion. Additional foci of edema type signal is noted medially within the talus which is nonspecific but could represent contusions given the patient's history. A small amount of fluid is noted within the anterior and posterior recesses of the subtalar joint which is nonspecific in nature.
1. Nonvisualization of the anterior talofibular ligament likely reflecting chronic tear given the patient's history.2. Tibiotalar cartilage defects with other findings as described above.