36-year-old male with torn posterior tibial tendon. Also, comment on the talar head and neck sclerosis on recent CT examination. Is this a stress fracture or anatomic variant? TENDONS: There is a longitudinal split tear of the posterior tibialis tendon affecting the distal 5 cm of the tendon. The posterior tibialis tendon appears thickened with intermediate signal abnormality consistent with tendinosis. There is circumferential fluid within the tendon sheath which may reflect a mild tenosynovitis. The remainder of the flexor tendons appear intact. The peroneal tendons appear intact. The extensor tendons appear intact. The Achilles tendon appears intact.LIGAMENTS: There is increased signal abnormality about a poorly visualized ATFL consistent with partial thickness tearing. There is increased signal abnormality in the subcutaneous soft tissues in the surrounding area. The lateral collateral ligament complex otherwise appears intact. The distal tibiofibular syndesmotic complex appears intact. The visualized components of the deltoid ligament appear intact.ARTICULAR SURFACES AND BONE: Note is made of linear low signal abnormality within the head and neck of the talus corresponding to sclerosis seen on recent CT examination. No increased signal abnormality is identified to suggest an acute process/stress reaction of the talus. There is increased signal abnormality within the anterior and lateral aspect of the tibial plafond which may represent a subchondral fracture versus bone contusion. No articular cartilage defects are identified. The tibiotalar joint alignment is anatomic. There is sclerosis and osteophyte formation about the talonavicular joint consistent with osteoarthritic changes.ADDITIONAL
1. Longitudinal split tear of the posterior tibialis tendon.2. No evidence to suggest an acute stress reaction of the talus as clinically questioned.3. Subchondral fracture versus bone contusion of the anterolateral tibial plafond.4. Near complete rupture of the ATFL.