Reason: right ankle and shin pain for 2 weeks, s/p lung transplant, diabetic, r/o Charcot joint. History: as noted above The flexor, extensor, and peroneal tendons appear intact. The Achilles tendon is normal in appearance. The distal tibiofibular syndesmotic complex appears intact. The lateral collateral ligament complex appears intact. The imaged components of the deltoid ligament appear intact. As seen on the recent radiographs, there is periosteal reaction along the distal tibial metadiaphysis which is most prominent medially. There is patchy edema type signal within the distal tibial diaphysis that extends off of the field of view of this study. This signal abnormality is most prominent along the medial aspect of the distal tibial metadiaphysis where it assumes a somewhat curvilinear orientation, perhaps representing a stress fracture, but this is equivocal. The remaining bone marrow signal intensity is normal. There is a small amount of fluid within the tibiotalar joint, but no large effusion. We see no findings to suggest neuropathic arthropathy. There is diffuse subcutaneous edema which extends along the dorsum of the foot, appearing similar to the prior study.
1. Nonspecific subcutaneous edema.2. Edema within the distal tibia which extends off of the field of view of this ankle study is nonspecific, but is associated with a poorly defined curvilinear focus of signal abnormality, raising the possibility of a stress fracture. This could be followed with repeat radiographs if clinically warranted.