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)

Case 1 - 17-year-old female woke up with a painful swollen right foot

Case 2 - 64-year-old female with pain in lateral aspect of right ankle

Case 3 - 24-year-old male presents with inversion injury on right ankle

Case 4 - 58-year-old male with right ankle pain

Case 5 - 28-year-old female with left ankle pain

Case 6 - 48-year-old male presents with pain in posterior right calcaneus

Case 7 - 58-year-old male presents with mass on left foot

Case 8 - 14-year-old female presents with pain in right ankle

Case 9 - 11-year-old female presents with lump on third digit of right foot

Case 10 - 18-year-old female presents with painful mass on left foot

Case 11 - 58-year-old male presents with right foot fracture.

Case 12 - 54-year-old male with pain in right ankle

Case 13 - 55-year-old male presents with chronic right ankle pain

Case 14 - 59-year-old female presents with right foot pain

Case 15 - 57-year-old female presents with left plantar midfoot pain

Case 16 - 76-year-old male presents with infection in the right foot

Case 17 - 42-year-old female presents with mass in right foot

Case 18 - 20-year-old male presents with left foot pain at the anterior midfoot

Case 19 - 42-year-old male patient presents with left lateral foot pain

Case 20 - 68-year-old female presents with right midfoot pain

Case 21 - 17-year-old male presents with right foot pain

Case 22 - 59-year-old male presents with right foot infection

Case 23 - 61-year-old female presents with left foot pain

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

Case 25 - 17-year-old male presents with pain on top of right foot

Course Evaluation

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

<div>HISTORY:&#160;This 58-year-old male presents with right ankle pain.(QUIZ ANSWER) PRIMARY FINDING:&#160;Haglund deformity.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: Hypertrophic Achilles tendinopathy with foci of mid substance interstitial microtearing is noted punctuated by enthesopathic insertional footprint tear:&#160;&#160;a. Superior posteromedial sharp-edged Haglund deformity.&#160;&#160;b. Supracalcaneal undersurface fraying-type tear and active inflammation with supracalcaneal secondary bursitis.&#160;&#160;c. Peeling of the mid to inferior footprint in the retrocalcaneal region.&#160;&#160;d. Traction enthesopathic erosion and stress reaction.&#160;&#160;e. Kager's space swelling.&#160;&#160;f. Consider superimposed secondary CPPD or crystalline deposition due to the chronicity and extent of inflammation.&#160;&#160;Due to altered mechanics of weightbearing, inferolateral subtalar bursal cyst so-called "stem ligament cyst" projecting dorsolaterally.&#160;&#160;Ankle joint unremarkable.&#160;&#160;Sinus tarsi ligaments normal.&#160;&#160;Ankle ligaments normal although the stem ligament bursal cyst sits directly atop the anterior talofibular ligament.&#160;&#160;Medial tendon group normal.&#160;&#160;Lateral tendon group normal.&#160;&#160;Anterior tendon group normal.&#160;&#160;Skeleton normal with type 2 accessory navicular identified. This, with the exception of the enthesopathic changes and Haglund deformity of the calcaneus.&#160;&#160;Plantar fascia normal.&#160;&#160;CONCLUSION:&#160;&#160;Multifocal areas of interstitial microtearing of the Achilles punctuated by prominent Haglund deformity and undersurface fraying-type tear whose depth is approximately 20% or less of a hypertrophic tendon. Subtle peel phenomenon of the mid to inferior footprint with enthesopathic calcaneal erosions and sharp-edged pump-bump.</div>

Case

What is the primary finding in this case?