Female 38 years old; Reason: Achilles tear? Ankle instability. History: Ankle instability. Pain and swelling of achilles TENDONS: The anterior fibers of the distal Achilles tendon appear minimally convex with minimal streaky increased signal, which may represent minimal tendinosis, however this is equivocal and appears similar to that seen on the prior study. No Achilles tendon tear is seen. There is mild edema in the pre-Achilles fat which may reflect mild inflammation or bursitis, though this also appears similar to the prior study. There is mild edema in the superior aspect of the posterior calcaneus, which is likely reactive and related to the aforementioned soft tissue inflammation. There is perhaps a minimal Haglund deformity of the calcaneus. The remaining tendons are within normal limits. LIGAMENTS: The anterior talofibular ligament is attenuated, perhaps reflecting prior injury though appearing similar to the prior study. The calcaneofibular and posterior talofibular ligaments are intact. The distal tibiofibular syndesmosis is intact. Loss of the normal fatty striations of the deltoid ligament may reflect prior injury, however this appears similar to the prior study. ARTICULAR SURFACES AND BONE: Again seen is the small focus of increased T2 signal in the medial aspect of the talar dome, which may represent a degenerative cyst or old osteochondral defect and appears similar to that seen on the prior study. Other than the aforementioned calcaneal edema, no additional bone abnormality is seen.ADDITIONAL
1. Mild inflammatory changes in the pre-Achilles fat in the approximate location of the retrocalcaneal bursa, with mild reactive edema in the underlying calcaneus. There is perhaps minimal tendinosis of the distal Achilles tendon, however this is equivocal and is unchanged from the prior study.2. Other findings as described above, appearing similar to the prior study.