Chronic recurrent Achilles tendinitis. Lateral posterior calcaneal pain. Evaluate Achilles and ankle ligaments. There is a small cyst within the posterior calcaneal tuberosity laterally just beneath the insertion of the Achilles tendon, with surrounding marrow edema. There are small linear foci of increased signal intensity within the adjacent Achilles tendon likely represent insertional interstitial tears, but otherwise the Achilles tendon appears normal. The remaining ankle tendons are normal. Signal intensity of the remaining bone marrow is normal. There is thickening of the anterior talofibular ligament with what appears to be a small ossicle in the substance of the ligament, suggesting prior trauma. The calcaneofibular ligament and posterior talofibular ligament are within normal limits. The distal tibiofibular syndesmotic complex appears normal. Mild heterogeneity of the deep tibiotalar component of the deltoid ligament may reflect old trauma as well. There are tiny tibiotalar joint osteophytes suggesting mild osteoarthritis. There is an os trigonum posterior to the talus. I see no osteochondral defect. There is a small amount of fluid within the tibiotalar and subtalar joints but no large effusion. There is mild subcutaneous edema involving the lower leg and ankle, nonspecific.
1.Enthesopathic changes at the Achilles insertion on the calcaneus, including mild interstitial insertional tearing of the Achilles tendon and cyst formation/edema in the underlying calcaneus.2.Findings suggestive of old injury to the anterior talofibular ligament; other findings as above.