Date : 00.00.00
Name of the Patient : Abc XyzRulmn / M / 45 yrs.
Referred by : Dr. Abc Xyzenoy / Dr. Abc Xyzgsarkar
Examination : M.R.I. of the Left Ankle.
CLINICAL PROFILE :
C/O pain in the left ankle with swelling since 1 month.
Patient was kept in a plaster.
M.R.I. of the left ankle was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
4 mm thick T1 Weighted and STIR coronal images.
4 mm thick T1 Weighted and GRASS (with fat saturation) sagittal images.
There is an ill-defined, hypointense signal on the T1 Weighted images in the anterior portion of the calcaneum. This is seen to turn hyperintense on the T2 Weighted, STIR and Gradient images. There is slight thinning of the cortex in that region. Small well-circumscribed areas with similar signal characeteristics are seen within the talus and calcaneum adjacent to the talo-calcaneal joint.
Fluid is seen along the flexor hallucis longus tendon.
The rest of the visualized tendons and ligament show normal signal intensity.
The MRI features are suggestive of :
1. Altered signal in the anterior portion of the calcaneum is not specific for a single etiology (? bone edema).
2. Minimal fluid along the flexor hallucis longus tendon.
In the given clinical setting, reflex sympathetic dystrophy
syndrome should be excluded.