MRI OF THE LEFT ANKLE
HISTORY: Tendinitis, retrocalcaneal spur, pain.
TECHNIQUE: Multiplanar multisequential MR images were obtained.
COMPARISON: There are no prior studies for comparison.
FINDINGS: There is a hypertrophic partial tear of the Achilles tendon most
pronounced at the distal attachment with cross-sectional dimension of the
Achilles tendon measuring approximately 9 mm in maximal AP dimension. There
are vertical striations of increased signal indicating disorganized collagen fibers
with bright signal intensity at the insertion as a result of disruption of the insertion
involving approximately 50-60% of the hypertrophied cross-section. There is also
a retrocalcaneal enthesophyte forming along the superficial inserting fibers of the
Achilles tendon as well as minor retrocalcaneal and minor adventitious
retroachilles bursitis. Mild inflammation of the paratenon of the Achilles tendon is
also noted as well as reactive edema of Kager's triangle. No discrete fluid-filled
gap to indicate a complete Achilles tendon tear. No stress fracture of the
calcaneus.
Plantar fasciitis is noted. There is no specific MRI evidence for a superimposed
acute component. There is no fracture or osteonecrosis. There is no ankle joint
or subtalar joint effusion. The region of the sinus tarsi is unremarkable. The
anterior tibialis tendon, extensor hallucis longus and extensor digitorum longus
tendons are intact. The PTT, FDL and FHL tendons are normal. Henry's knot
level is unremarkable. The contents of the tarsal tunnel are unremarkable. The
tibial neurovascular bundle as well as the proximal aspects of the medial and
lateral plantar nerves are unremarkable. The peroneal tendons are intact without
dislocation or subluxation. The superior peroneal retinaculum is intact. The ATF,
CF and PTF ligaments are intact. Deep deltoid as well as the spring ligament are
intact.
IMPRESSION:
1. There is a hypertrophic partial tear of the Achilles tendon most
pronounced at the distal attachment with cross-sectional dimension of the
Achilles tendon measuring approximately 9 mm in maximal AP dimension.
There are vertical striations of increased signal indicating disorganized
collagen fibers with bright signal intensity at the insertion as a result of
disruption of the insertion involving approximately 50-60% of the
hypertrophied cross-section. There is also a retrocalcaneal enthesophyte
forming along the superficial inserting fibers of the Achilles tendon as well
as minor retrocalcaneal and minor adventitious retroachilles bursitis. Mild
inflammation of the paratenon of the Achilles tendon is also noted as well
as reactive edema of Kager's triangle. No discrete fluid-filled gap to
indicate a complete Achilles tendon tear. No stress fracture of the
calcaneus.
2. Chronic plantar fasciitis.