Reason: eval for signs of crystal arthropathy, ankle pain, difficulty ambulating History: as above TENDONS: There is lobulated fluid signal intensity within the tendon sheath of the flexor hallucis longus, and to a lesser degree, the flexor digitorum longus tendon sheath, just proximal to the level of the master knot of Henry indicating a tenosynovitis. The peroneal tendons appear intact. The Achilles tendon appears intact. The anterior tendons are unremarkable.LIGAMENTS: There is disruption of the anterior talofibular ligament. There is a tiny avulsion off the distal fibular tip at the insertion of the posterior talofibular ligament (image 6 series 5). The calcaneofibular ligament is also poorly visualized and may be disrupted. The imaged portion of the deltoid ligament is thickened with intermediate signal intensity suggesting prior injury or sprain. Portions of the ligament are poorly visualized suggesting partial disruption. There is also a tiny ossicle along the distal tip of the medial malleolus which may reflect prior trauma.ARTICULAR SURFACES AND BONE: There is bone marrow signal abnormality within the distal fibula which may represent a contusion in the correct clinical context. No discrete fracture line is identified. There is bone marrow signal abnormality within the posterior aspect of the tibial plafond which may be degenerative in etiology. No convincing erosions are evident.ADDITIONAL
1. Disruption of the ATFL as well as probable calcaneofibular ligament disruption. There is also a tiny avulsion fracture of the distal fibula at the insertion of the PTFL, which may be subacute or chronic in etiology. There is bone marrow signal abnormality within the distal fibula in the surrounding area, which is nonspecific, but may represent a bone contusion in the correct clinical context. 2. Findings indicating an intersection syndrome with tenosynovitis involving the flexor hallucis longus and flexor digitorum longus tendons as described above.3. Partial disruption of the imaged portions of the deltoid ligament with a tiny ossicle along the distal tip of the medial malleolus likely reflecting prior remote trauma.4. Osteoarthritis of the ankle and midfoot.