38-year-old female with pain. Rule out ankle ligamentous injury. TENDONS: The flexor and extensor tendons appear intact. The peroneal tendons appear intact. The Achilles tendon is normal in appearance.LIGAMENTS: The lateral collateral ligament complex appears intact. The distal tibiofibular syndesmotic complex appears intact. The imaged components of the deltoid ligament appear intact.ARTICULAR SURFACES AND BONE: There is increased bone marrow signal abnormality within the distal fibula and talus which may reflect a combination of bone contusion and degenerative change. Again seen is a comminuted fracture of the calcaneus with intra-articular extension to involve the posterior and middle facet of the subtalar joint as well as extending anteriorly to involve the calcaneocuboid articulation. There is serpentine signal abnormality within the calcaneal fracture fragment about the posterior facet of the subtalar joint, consistent with avascular necrosis. There is linear decreased signal abnormality within the body of the talus along the anterior aspect of the posterior facet of the subtalar joint which may represent a nondisplaced subchondral fracture. There is narrowing of the anterior aspect of the tibiotalar joint with subjective thinning of the articular cartilage. The tibiotalar joint alignment is otherwise anatomic. Mild degenerative changes affect the talonavicular articulation.ADDITIONAL
Comminuted fracture of the calcaneus with intra-articular extension as described above. There is avascular necrosis of the calcaneal fracture fragment about the posterior facet of the subtalar joint. Probable nondisplaced subchondral fracture of the talus as described above. No evidence of ligamentous injury, as clinically questioned.