Upcoming Events
Log In
Pricing
Free Trial

Wk 9, Case 1, Foot/Ankle MR - Review

HIDE
PrevNext

Report

Patient History

19 F with lateral and anterior/dorsal ankle pain, swelling, decreased ROM

Findings

Osseous Structures: No fracture or dislocations noted. No intramedullary lesions. The medial and lateral malleoli are intact. No osteochondral injuries of the tibial plafond or talar dome. No posterior or mid talar arthrosis. Midfoot without arthropathy. Normal Lisfranc joint.

Ligaments: The lateral low ankle ligaments (anterior talofibular, posterior talofibular and calcaneofibular) and high ankle ligaments including the anterior tibiofibular, posterior tibiofibular and syndesmosis are intact. The deltoid ligament complex is intact.

Muscles/Tendons: Peroneus muscles, extensor and flexors without evidence of tendinopathy, tenosynovitis, tears or myositis.

Soft Tissues: Lobulated intermediate to low T1 and T2 signal intensity intraarticular lesion located in the hindfoot adjacent to the posterior talar process at the subtalar joint measuring 2.4cm x 3.2cm x 1.6cm (AP, transverse and CC).

The plantar fascia is without thickness. No evidence of traction enthesophyte at the calcaneal tuberosity. No inflammatory changes or tears. The heel fat pad is without edema.

Neurovascular: Tarsal tunnel and its contents are normal. No space-occupying lesions within it.

Moderate tibiotalar and subtalar joint effusion without reactive synovitis. Mild periarticular soft tissue swelling.

Impressions

1. Lobulated “frond-like” intraarticular lesion with low T1 and T2 signal intensity containing hemosiderin deposits located in the hindfoot adjacent to the posterior talar process measuring 2.4cm x 3.2cm x 1.6cm (AP, transverse and CC) representing pigmented nodular synovitis (giant cell tumor of the tendon sheath). No osseous erosions.

2. Moderate tibiotalar and subtalar joint effusion without reactive synovitis.

3. No osseous, ligamentous or tendinous injuries.

Case Discussion

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Gitanjali Bajaj, MD

Assistant Professor

University of Arkansas for Medical Sciences

Edward Smitaman, MD

Clinical Associate Professor

University of California San Diego

Brian Y. Chan, MD

Assistant Professor of Musculoskeletal Radiology

University of Utah

Tags

Musculoskeletal (MSK)

MRI

Foot & Ankle

© 2024 Medality. All Rights Reserved.

Contact UsTerms of UsePrivacy Policy