History of split tear of the tibialis posterior, patient still having pain and swelling. Please revaluate TENDONS: Persistent enlargement of the tibialis posterior with internal signal and split tear as previously observed in 2013. Abnormal changes are again most pronounced at the level of the tibiotalar junction and associated with mild surrounding fluid. Changes again traverse approximate over a 4 cm length. It is difficult to determine if this represents a recent injury or chronic finding given the appearance, however it also may represent a mild combination. Increased signal within the tibialis posterior is largely central without discrete evidence of retraction or new abnormalities either more proximally or distally.The remaining tendons are otherwise intactLIGAMENTS: ATFL and PTFL and the calcaneofibular ligaments are otherwise intact. The deltoid is grossly intact.ARTICULAR SURFACES AND BONE: Underlying osseous structures are otherwise similar with minimal degenerative changes and normal marrow signal throughout. The previously observed minimal changes suggesting synovitis again cannot entirely be excluded and may account for mild diffuse signal changes within the sinus tarsus, unchanged. ADDITIONAL
Overall residual or recurrent longitudinal split tear of the tibialis posterior. Appearance similar to prior study