There are multiple subcutaneous soft tissue masses and fusiform areas of tendinous thickening with heterogeneous T1 and T2 weighted signal change, and mild heterogeneous enhancement. The changes are most pronounced at the distal Achilles tendon, which demonstrates a striated appearance.
Other tendinous involvements are seen in the tibialis anterior tendon (at the level of talonavicular joint), peroneus longus tendon, flexor hallucis longus (at the level of the midfoot), and proximal plantar fascia. The subcutaneous masses are noted along the outer aspect of the lateral malleolus, lateral to the fifth metatarsal base, first toe, second toe and fifth toe.
Pressure erosions of the first distal phalanx are seen. Moderate Achilles peritendinitis and mild peroneal tenosynovitis are noted.