Pain and swelling of the Achilles tendon insertion unresponsive to conservative treatment. TENDONS: There is perhaps slight thickening of the Achilles tendon distally with a prominent enthesophyte at the insertion on the calcaneus indicating insertional tendinosis. We see no discrete tear of the Achilles tendon. The anterior and medial tendons appear intact. There appears to be a longitudinal split tear of the peroneus brevis tendon as it courses posteriorly beneath the fibular tip of questionable significance. There is minimal if any associated peroneal tenosynovitis.LIGAMENTS: The study is not protocoled for optimal evaluation of ankle ligaments. The anterior talofibular ligament appears slightly thinned which may represent old injury, but this is equivocal. The calcaneofibular and posterior talofibular ligaments appear intact. The distal tibiofibular syndesmotic complex appears intact. The visualized components of the deltoid ligament appear intact.ARTICULAR SURFACES AND BONE: Mild osteoarthritis affects the ankle and midfoot. Bone marrow signal is unremarkable. We see no osteochondral defects.ADDITIONAL
1.Mild insertional Achilles tendinosis without tear.2.Mild nonspecific subcutaneous edema.3.Mild edema type signal in the flexor hallucis longus muscle which is nonspecific but may represent subacute atrophy or mild strain.4.Longitudinal split tear of the peroneus brevis of questionable significance.5.Other findings as described above.