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Ankle joint arthropathy

Case contributed by Andrew Lawson
Diagnosis certain

Presentation

Diabetic with ankle pain

Patient Data

Age: 70
Gender: Male
mri

Diffuse synovitis throughout the ankle with full-thickness loss of the articular cartilage at the tibiotalar joint. Cartilage loss is also present, but to a lesser degree, at the mid tarso-calcaneal joint, calcaneocuboid, talonavicular and multiple tarsal joints. Post contrast enhancement is visible of the bones adjacent to the aforementioned joints. Extensive tenosynovitis of the flexor hallucis longus tendon. Although a hindfoot valgus deformity is demonstrated, the supporting tendons are intact. The deltoid, ATFL and PTFL are intact. The tibialis posterior, peroneus brevis and longus tendons are intact.

Comment The findings are consistent with long-standing chronic inflammatory arthropathy with features of polyarticular inflammatory change and osteitis.

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