44 year old male with right ankle pain and knee pain has been unable to bear weight for several days. Evaluate for fracture. TENDONS: The Achilles tendon is unremarkable. The medial tendons of the ankle are unremarkable. The peroneus brevis appears normal. The peroneus longus tendon is markedly attenuated as it courses along the lateral margin of the anterior calcaneus compatible with a near full thickness tear. We see no fluid immediately adjacent to this portion of the tendon and therefore suspect this to be a chronic process. The anterior portion of the tendons appear normal.LIGAMENTS: The ATFL appears irregular, likely representing prior injury. The calcaneal fibular ligament appears intact although intermediate signal within the ligament may represent prior injury. The PTFL is unremarkable. The distal tibiofibular syndesmotic complex appears normal. The deltoid ligament is grossly intact.ARTICULAR SURFACES AND BONE: We see no fracture line. There is mild edema within the talar dome medially with focal loss overlying the cartilage. This could represent a small post traumatic osteochondral defect or simply a manifestation of long standing osteoarthritis. There is slight prominence of the "posterior malleolus" of the distal tibia which may reflect old trauma. There is associated mild subchondral signal abnormality that we suspect is degenerative. There is a small amount of fluid in the tibiotalar joint but no large effusion. There is an os trigonum posterior to the talus with a small cyst anteriorly. ADDITIONAL
1. Soft tissue swelling that is nonspecific.2. Mild osteoarthritis affects the tibiotalar joint as described above.3. Marked attenuation of the peroneus longus tendon suggesting a near full thickness tear that we suspect is chronic.3. No fracture line is evident.