Presentation
Diffuse pain and swelling around ankle joint
Patient Data
Gross tibialis posterior tendinopathy is seen with significant thickening and interstitial tears involving supramalleolar, retromalleolar and inframalleolar segments. Significant surrounding soft tissue edema is seen.
Thickening, irregularity and partial tears of the spring ligament is seen with mild edema in deep fibers of the deltoid ligament.
Significant edema is seen in sinus tarsi with marrow edema in the lateral process of the talus.
Other findings:
A longitudinal split tear of the peroneus brevis tendon is seen, likely starting above the level of the lateral malleolus and mildly extending inferiorly. Mild tendinosis of the peroneus longus tendon is seen which is encased by torn peroneus brevis tendon.
Osteochondral defect, measuring approx. 3.5mm in transverse and 6mm anteroposterior dimensions is seen along medial talar dome with associated marrow edema. Mild marrow edema is also seen along lateral talar dome with partial loss of overlying articular cartilage.
Anterior talofibular ligament is not well visualized, likely torn.
Mild achilles tendinosis is seen with small spur along its calcaneal attachment.
Small plantar calcaneal spur is seen with no obvious evidence of plantar fasciitis in present scan.
Degenerative changes are seen involving 2nd , 3rd and 4th tarsometatarsal joints with subchondral erosions, marrow edema and marginal osteophytes.
Case Discussion
Tibialis posterior tendinopathy, partial tears of the spring ligament, sinus tarsi, and lateral process of talus edema are suggestive of tibialis posterior tendon dysfunction. This is one of the causes of ankle pain in this patient with multiple other findings.
Unable to process the form. Check for errors and try again.