Case Challenge

Foot & Ankle

Stephen J Pomeranz

Gain confidence interpreting Foot & Ankle MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME. Try it free!

Case Review

Musculoskeletal (MSK)

Post-Course Activities

This Power Pack is comprised of 25 unique Foot / Ankle MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Foot & Ankle MRI Cases

Case 24 - 22-year-old male presents with left ankle swelling and pain

<div>HISTORY:&#160;This 22-year-old male presents with left ankle injury one week ago with swelling and pain.(QUIZ ANSWER) A FINDING IN THIS CASE:&#160;All of the above.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Marked bone marrow edema along the lateral aspect of the talus consistent with microtrabecular fracture.Additionally, complete tear of the anterior talofibular ligament with adjacent diffuse soft tissue swelling and subcutaneous hematoma. Posterior talofibular ligament appears intact.Calcaneofibular ligament is torn as well as the peroneal retinaculum.Anterolateral peroneus tertius muscle tendon unit is injured anteriorly. Capsule is ruptured laterally.Peroneus longus tendon insertion sprain of the first digit.Large os trigonum is consistent with chronic posterior impingement.Chronic appearing posterior subtalar arthrosis.Peroneus quartus muscle.Loculated fluid collection within the subcutaneous fat along the inferior margin of the calcaneus consistent with hematoma and likely related to recent trauma.&#160;The osteochondral surfaces are intact. No OCD or erosion is present.&#160;No signs of intraosseous ganglion.&#160;The medial collateral complexes are intact.&#160;The syndesmosis is intact, including the interosseous membrane, anterior tibiofibular and posterior tibiofibular ligaments.&#160;The medial and lateral tendon groups are intact. Achilles is intact.&#160;CONCLUSION:1. Microtrabecular fracture/fractures lateral talus with diffuse ankle swelling and lateral malleolar hematoma and soft tissue swelling. Additionally, complete tear of the anterior talofibular ligament with adjacent subcutaneous hematoma.1b. Calcaneofibular ligament tear.1c. Peroneal retinaculum tear.1d. Anterolateral peroneus tertius muscle tendon unit injury anteriorly.&#160;2. Loculated fluid collection within the subcutaneous fat along the inferior margin of the calcaneus consistent with hematoma and likely related to recent trauma.&#160;3. Large irregular os trigonum consistent with chromic posterior impingement.&#160;4. Chronic posterior subtalar arthrosis.5. Small heel pad hematoma.6. Peroneus quartus muscle.7. Capsular rupture laterally.8. Peroneus longus tendon insertion sprain on 1st digit.</div>

Case

Microtrabecular fracture(s) lateral talus

Loculated fluid collection within the subcutaneous fat along the inferior margin of the calcaneus

Which of the following is a finding in this case?