50-year-old man with medial ankle pain and swelling. TENDONS: There is a small amount of fluid within the sheath of the posterior tibialis tendon, flexor digitorum tendon, and flexor hallucis tendon. We see no findings to suggest a tendon tear. There is a small amount of fluid adjacent to the distal fibers of the posterior tibialis tendon just proximal to its insertion on the navicular bone, which may represent a very mild peritendinitis, but this is equivocal. The Achilles tendon appears normal, however, there is distention of the retrocalcaneal bursa indicating a bursitis. There are small quantities of fluid within the peroneal tendon sheaths, not necessarily of any clinical significance. There is increased signal intensity along the posterior margin of the peroneus brevis tendon as it courses beneath the fibular tip, which may represent a small partial-thickness longitudinal tear, but the clinical significance of this finding is uncertain. The peroneus longus tendon appears intact. The extensor tendons appear intact.LIGAMENTS: The lateral collateral ligament complex appears intact. The distal tibiofibular syndesmotic complex appears intact. The visualized components of the deltoid ligament are intact.ARTICULAR SURFACES AND BONE: There is a tibiotalar joint effusion, but the ankle joint otherwise appears normal without evidence of an osteochondral defect. There is also a small amount of fluid extending into the anterior and posterior recesses of the subtalar joint. Mild osteoarthritis affects the ankle and midfoot. We see no fracture.ADDITIONAL
1. Small amount of fluid within the posterior tibialis tendon sheath and possible mild peritendinitis of the distal fibers of the posterior tibialis tendon. We see no evidence of tendon tear/rupture.2. Hematoma within the subcutaneous fat medial to the posterior tibialis tendon.3. Retrocalcaneal bursitis and tibiotalar joint effusion along with diffuse subcutaneous edema.4. Other findings as described above.