Got the results of my right ankle MRI (the left one has been the worst for quite a while). I've been keeping an eye on a cyst since June and it became much more inflamed and painful. The cyst is less of a single lump now and more like a swollen ankle.
Results weren't too surprising. Wear and tear from nearly 150,000 miles. Nothing to really do about it now unless the pain becomes too much. Time will tell.
EXAM DESCRIPTION: MRI ANKLE RIGHT W WO CONTRAST
CLINICAL HISTORY: 56 y/o M with right ankle arthritis presents for evaluation of the palpable abnormality, question ganglion cyst.
COMPARISON: Right foot MRI dated 06/19/2014.
TECHNIQUE: An MRI of the right ankle was performed without and with intravenous Dotarem. Multiplanar imaging includes T1, PD, T2, and STIR weighted sequences.
FINDINGS: Imaging was treated by metal reduction techniques.
Bones: There is extensive marrow edema of the navicular with what appears to be osteochondral lesions at the talonavicular joint (for instance sagittal FSE STIR image 10). With subchondral marrow edema scattered elsewhere throughout the midfoot such as the talar head (sagittal FSE STIR image 10), the TMTs (sagittal FSE STIR image 12), and the anterior process of the calcaneus (sagittal FSE STIR image
Cartilage: Overall well maintained.
Joints: Pes planus.
-syndesmotic: The tibiofibular ligaments are favored intact.
-lateral: Grossly intact ATFL, CFL, and PTFL.
-medial: The deltoid ligament is favored intact as well.
Muscles and tendons:
-posterior: Normal Achilles.
-anterior: The extensor tendons are favored intact and normal, though there may be splaying of the flexor digitorum tendons near the expected location of the extensor retinaculum.
-lateral: Intact peroneus longus and brevis.
-medial: Intact PT, FHL, and FDL. A small amount of fluid in the tendon sheaths is favored physiologic.
-tarsal tunnel: Not effaced.
-sinus tarsi: Partial effacement.
Plantar fascia: Unremarkable.
Superficial soft tissues: Near the skin marker placed by the patient at the site of palpable abnormality is a multiloculated T2 hyperintense and nonenhancing cystic structure just anterior to the lateral margin of the tibial plafond and measuring 1.0 x 1.0 x 0.6 cm (sagittal FSE STIR image 14). This contacts and favored to partially
splay the extensor digitorum tendons.
Post-contrast enhancement: No abnormal postcontrast enhancement is identified, though evaluation is difficult.
IMPRESSION: 1. Palpable abnormality at the anterior ankle appears to correspond to a multilocular T2 structure, presumably a ganglion cyst, just anterior to the tibial plafond. This abuts and favored to partially splays the extensor digitorum longus tendons.
2. Pes planus with degenerative changes of the midfoot.