MRI RIGHT ANKLE
The ankle and subtalar joints appear normal. Very subtle areas of minor subchondral oedema are noted at the hallux and 2nd TMTJ. The cartilage here is preserved and elsewhere the visualised joints appear normal. There is no evidence of any dislocation.
There is a large sized corticated bone fragment lying at the distal aspect of the lateral malleolus. This incorporates the ATFL and partially the PTFL and CFL. It is difficult to be certain whether this represents an old avulsion injury or an accessory ossicle (sub fibulare). There is certainly some minor intraosseous cystic change at the interface with the lateral malleolus.
The lateral ligaments are intact as are the deep and superficial deltoid ligaments and spring ligament.
However moderate thickening to the anterior aspect of the superficial deltoid ligament is in keeping with a previous injury. There is a small amount of fluid within the tibialis posterior tendon sheath but the tendon itself appears normal.
At the peroneal groove of the plantar aspect of the cuboid, there is slight hyperintense thickening to peroneus longus tendon extending from this point up to and including its insertion at the plantar aspect of the base of the hallux metatarsal. This is in keeping with a severe strain and probable partial thickness avulsion injury.
The remaining medial and lateral tendons are intact and normal as is the Achilles tendon.
There is some minor hyperintense thickening to the plantar fascia in keeping with fasciitis with some entheseal oedematous changes within the calcaneal tuberosity.
Marrow elsewhere returns a normal signal. In particular, there is no evidence of a fracture.