50 year-old male with swelling and pain after soccer Best seen on the T1 axial post contrast images is thickening and enhancement of the synovium along the head and neck of the talus, along the plantar and lateral aspect of the navicular, and to a lesser degree along the calcaneocuboid joint, indicating synovitis. There is edema signal in the navicular and cuboid bones that is likely reactive in etiology. The cuneiforms and 5th metatarsal are incompletely imaged, although edema in these bones is also likely reactive in etiology. No discrete erosions are identified. A small amount of fluid in the tibiotalar joint is identified without frank effusion. There is mild edema along the superior aspect of the posterior calcaneal tuberosity with a thin curvilinear band of low T1 signal intensity that may represent a nondisplaced fracture, perhaps a stress fracture, albeit in a somewhat peculiar location. There is mild retrocalcaneal bursitis as well.The Achilles tendon appears normal. The medial ankle tendons are intact, although distally the flexor digitorum longus is obscured by synovitis. The peroneal tendons appear normal. The anterior tendons are intact. The lateral collateral ligament complex and distal tibiofibular syndesmotic complex appear normal.
1. Midfoot synovitis and bone marrow edema consistent with the patient's diagnosis of JIA. Please note that the distal extent of disease is not included on this ankle MRI exam.2. Findings suggesting a nondisplaced fracture (perhaps a stress fracture) of the superior aspect of the posterior calcaneal tuberosity with mild adjacent bursitis.