Swelling and pain over medial malleolus. Evaluate for cause of pain and swelling for several months. Question of stress fracture. Multiple normal x-rays. TENDONS: Ankle:There is enlargement of the posterior tibialis tendon with increased fluid sensitive signal surrounding the tendon compatible with tendinopathy. Additionally there is a small amount of fluid sensitive signal around the anterior tibialis tendon which is abnormal. The remaining tendons of the anterior and lateral compartments are normal in appearance. There is a thin longitudinal stripe of high T1 and faint T2 signal within the Achilles tendon which may be related to remote injury. Forefoot/midfoot:The tendons appear intact. LIGAMENTS: Ankle:The deltoid ligament is intact. The anterior and posterior talofibular ligament is intact.Forefoot/midfoot:The ligaments appear intact.ARTICULAR SURFACES AND BONE: Ankle:A T2 hyperintense lesion within the lateral aspect of the navicular bone likely represents a cyst. No fracture is evident. There is mild edema of the medial aspect of the anterior talus.Forefoot/midfoot: Bone marrow signal is within normal limits. No fracture is evident.ADDITIONAL
1. Enlarged posterior tibialis tendon with fluid in the tendon sheath is compatible with tendinopathy and tenosynovitis.2. Mild anterior tibialis tendon tenosynovitis.3. No fracture is evident.