Male 55 years old Reason: Evaluate soft tissue mass left ankle History: Palpable STM medial left ankle at level of medial malleolus and posterior, firm to palpate, non-mobile, horizontal, +pain with +Tinels Markers are placed along the posteromedial aspect of the ankle, presumably representing site of palpable mass. Mild reticulation of the underlying subcutaneous fat is present which may represent edema or scarring, but we see no distinct soft tissue mass. There is a large enthesophyte emanating from the calcaneus posteriorly at the insertion of the Achilles. There is slight thickening of the distal Achilles, which otherwise appears normal.Minimal osteoarthritis affects the midfoot. Small ossicles distal to the medial malleolus, which may represent chronic ligamentous injury. Cysts are present in the medial malleolus as well.Mild enhancement of the tendon sheath of the distal posterior tibialis tendon suggests mild tenosynovitis.
1.We see no discrete soft tissue mass. There is mild reticulation of the subcutaneous fat of the medial ankle which may reflect edema or scarring.2.Findings suggestive of mild tenosynovitis of the posterior tibialis tendon.3.Large enthesophyte at the insertion of the Achilles.4.Findings suggestive of prior injury to the deltoid ligament and mild osteoarthritic changes as above.