Presentation
Soccer player with history of multiple frequent ankle injuries and pain in the ankle.
Patient Data
On MRI we see rounded high PD+fat sat and low T1 signal within the calcaneus in a typical subtalar location, venous vessels run out of it in a stellar manner.
Case Discussion
A subtalar subcortical signal abnormality in the cancellous bone of the calcaneus near the insertion of the cervical and interosseous ligaments is a benign incidental finding, representing prominent vascular remnants and should not be mistaken for disease.
On histology, this lesion looks like thin cortical bone, which is surrounded by normal yellow, fat-containing bone marrow and many widened vascular spaces.
The main differential diagnosis is a subtalar degenerative subchondral cyst (geode), but having approximately the same look such cyst should be located subarticular in location. Simple unicameral bone cyst differs from this phenomenon, because having the same signal it lacks septations, why it is called unicameral.