sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc XyzMarchawlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of the Right Ankle & Foot.

CLINICAL PROFILE :

C/O severe pain and swelling over the right foot since 1 month.
Exploration of the right ankle on 00.00.00. Dirty fluid aspirated.

EXAMINATION :

M.R.I. of the right ankle and foot 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 :

There is an ill-defined, hypointense signal on the T1 Weighted images involving the distal end of the tibia, laterally, dome of the talus, posteriorly and along the medial and posterior margin of the lateral malleolus. This signal appears hyperintense on the T2 Weighted and STIR images. Similar signal change is noted in the calcaneum and navicular bones adjacent to the calcaneo-navicular joint.

There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images around the lateral, anterior and posterior margins of the right ankle. This lesion also appears hyperintense on the T2 Weighted and STIR images. Similar soft tissue lesion is noted between the lateral malleolus and the talus and the sustenteculum tali.
..2/.







Scar of previous surgery is noted along the posterior margin of the lateral malleolus, with susceptibility artifacts in that region.

There is evidence of altered signal (hypointense on the T1 eighted images and hyperintense on the T2 Weighted images) in the subcutaneous fat around the right foot and right ankle which suggests cellulitis.

The rest of the visualized bones of the right ankle and foot show normal signal intensity.

The visualized tendons and ligament show normal signal intensity. No joint effusion is evident.

IMPRESSION :

1. Post-operative status.

2. Altered signal in the distal end of the tibia, lateral malleolus, talus, calcaneum and navicular bones as described is not specific for a single etiology. These changes most likely represent osteitis, in the given clinical setting. Soft tissue around the right ankle joint may represent inflammatory/infective granulation tissue. There is also evidence of cellulitis in the subcutaneous fat around the right foot and ankle.

The possibility of these changes being due to a neoplasm seems less likely.