Pain. Evaluate for fracture. There is soft tissue swelling, but I see no acute fracture. Osteoarthritis affecting the midfoot appears similar to that seen on the prior study. The distal Achilles tendon silhouette appears thickened which may simply reflect overlying soft tissue swelling, but if there is clinical concern for Achilles tendon tearing, then MRI may be considered for further evaluation.
Soft tissue swelling without fracture evident. If there is clinical concern for tendon injury, then MRI may be considered.