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| MRI ANKLE |
MRI coronal STIR section of ankle joint shows degenerative subchondral bone marrow oedema involving articular surface of lateral malleolus of fibula, lateral process of talus and calcaneum, loss of joint space, degenerative sub chondral cystic geodes in the lateral process of talus at subtalar joint without joint effusion.
The bone marrow edema in calcaneum is confined to the subjacent articulating surface and characteristically not present all along the cortex around the margins of the sinus tarsi on sagittal STIR. Possibility of lateral hindfoot impingement suggested.
If bone marrow edema in calcaneum is present all along the cortex around the margins of the sinus tarsi, this would not be characteristic and would instead suggest the different diagnosis, that of sinus tarsi syndrome.
There is associated diffuse thickening of anterior talo fibular ligament.
Osseous findings of lateral hindfoot impingement include degenerative changes like subchondral sclerosis, subcortical bone marrow edema at specific locations at the talus, calcaneus and or fibula, sub chondral cystic geodes in advanced cases.
The incidence of calcaneofibular impingement is somewhat lower than talocalcaneal impingement, with calcaneofibular impingement present almost exclusively in individuals shows changes of talocalcaneal impingement, suggesting that the talocalcaneal osseous changes occur before the calcaneofibular changes.
