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Name of the Patient : Abc Xyzna J. Plmn / F / 42 yrs.
Referred by : Dr. Abc Xyzy B. Shah.
Examination : M.R.I. of the Left Ankle.

CLINICAL PROFILE :

C/O pain in the left ankle with swelling (on & off) since 2 years.

EXAMINATION :

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 sagittal images.

OBSERVATION :

The medial malleolus appears as a well-corticated, separate but undisplaced bone fragment (separate from the distal tibia). The lateral malleolus and the ankle mortis per se show normal alignment. Fluid is noted in the left ankle joint and in the tibialis posterior tendon sheath.

There is an ill-defined, hyperintense signal on the T2 Weighted, STIR and GRASS images in the soft tissues of the heel pad of the left ankle medially (scans 106.9, 10, 104.1,2). This lesion appears hypointense to normal fat on the T1 Weighted images.

The rest of the visualized bones show normal configuration and signal intensity.
Scan-00003


The visualized ligaments show normal signal intensity.

IMPRESSION :

1. A well-corticated, separate but undisplaced medial malleolus (separate from the distal tibia) may either suggest an old, non-united fracture of the medial malleolus or may represent a separately ossified and non-united medial malleolus.

2. A small left ankle joint effusion.

3. Fluid along the tibialis posterior tendon may suggest tenosynovitis.

4. Altered signal in the soft tissues of the heel pad of the left ankle medially, may be due to trauma or an inflammatory/infective etiology.



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