NAME OF STUDY: Left ankle and foot MRI.
Numerous images are taken in different orthogonal planes using different sequences. The ankle is not done as a full separate study but was incorporated into those images of the foot due to some positioning requirements of the patient. This is felt adequate to evaluate the ankle mortise but does not evaluate the distal tibia well. The bony structures of the ankle, the hindfoot, midfoot, and forefoot show no fractures or gross destructive processes. There is, however, some high signal involving the base of the fifth metatarsal bone, which could indicate some inflammation and therefore does not rule out infection possibilities. Again, the cortex is grossly intact, and this is a mild change. The cuboid is not involved and the shaft of the fifth metatarsal bone is not involved. At this point, this only resides at the base of that fifth metatarsal bone. None of the other bony structures show any significant change to suggest that they are inflamed or infected as well.
There are some areas of soft tissue edema and thickening. This is noted particularly along the lateral aspect of the posterior talus area. This does not involve the bone. The soft tissues do appear edematous and in some cases thickened and this does go down to the fascial plane. Again, the bone is not involved. There is another area of soft tissue edema suggested again, laterally, slightly more over the midfoot region. Again, the bones do not appear involved. There is also some edema suggested directly over the forefoot dorsally. I do not know if that is due to dependent edema or inflammation, as it is not focal but generalized. Again, the underlying bony structures are not involved other than that one area already described. Also, I do not see gross tendinitis on this exam or significant synovial fluid increases to suggest synovitis.
IMPRESSION:
1. There are areas of soft tissue change and edema, particularly laterally, which do not involve the underlying bony structures and do suggest primarily focal soft tissue infection or cellulitis.
2. The only bone which does show some mild increased signal is at the base of the fifth metatarsal bone. There is no cortical disruption or growth, anatomical destruction of this area at this time. Again, this suggests some mild inflammation such that one might see with possible infection. The cuboid is not involved nor is the shaft of the fifth metatarsal bone.
3. Those images, which do include the ankle mortise, do not show osteochondral defects in that area or definite evidence of a loose joint body.
