Presentation
Left ankle joint pain and swelling
Patient Data
No evidence of talus osteonecrosis/avascular necrosis.
There is diffuse marrow infiltration in the distal tibial (epiphysial-metaphyseal region), talus and distal epiphysis of fibula returning low signal in T1 weighted images and high signal in T2 weighted images, showing intense contrast enhancement in post-contrast sequences.
Significant erosion of the articular surface of the tibia and talus is seen.
Minimal left ankle joint effusion with diffuse synovial thickening and enhancement is noted.
Diffuse inflammatory changes are visualized surrounding the left ankle joint with the presence of abscess collection in the medial aspect of the left ankle joint.
The tendinal structures in the anterior, lateral, and medial aspects of the left ankle joint show normal morphology and MR signal. No evidence of tendinal tear or tendinopathy.
Case Discussion
Features are of ankle joint septic arthritis associated with osteomyelitis of the talus and the lower extremity of the tibia as well as soft tissue inflammation with abscess collection as described above.
Additional contributor: Dr. Najibullah Rasouly