Could a ganglion or synovial cyst cause chronic ankle pain and popping sensation?
The distal syndesmotic ligaments are intact. The anterior talofibular and posterior talofibular ligaments are intact. However, there is a 12 x 3 x 2 mm fluid signal lesion centered within the posterior talofibular ligament, from which it likely arises. This is suspected to represent small ganglion versus less likely synovial cyst. The calcaneofibular ligament is intact. The deltoid ligament is unremarkable.
The tibialis posterior, flexor digitorum longus, and flexor hallucis longus tendons are intact. The peroneus brevis and longus tendons are intact. The extensor tendons are unremarkable. The Achilles tendon is unremarkable. However, there is increased T2 signal intensity deep to the Achilles tendon within Kager's fat pad consistent with Achilles paratendinitis.
Periarticular bone marrow edema and small osteophyte formation about the lateral/plantar calcaneal cuboid articulation. This is suspected to represent mild osteoarthrosis. Additional minimal bone marrow edema in the lateral cuneiform bone of indeterminate etiology. No other abnormal bone marrow signal intensity. No chondral lesions of the XXXXXXX dome. The subtalar joint is unremarkable.
The sinus tarsi is unremarkable. The tarsal tunnel is unremarkable. The plantar fascia is intact. No soft tissue mass. Physiologic amount of joint fluid. No abnormally localized fluid collections.
1. Intact peroneal tendons.
2. Suspect early osteoarthrosis at the lateral/plantar calcaneocuboid articulation.
3. Achilles paratendinitis.
4. Nonspecific marrow edema in the lateral cuneiform bone, possibly additional site of mild osteoarthrosis or marrow contusion.
5. 12 x 3 x 2 mm likely ganglion versus synovial cyst centered within the posterior talofibular ligament.
Synovial cyst is the only significant finding
I can certainly understand your concern and have worked through your attached query and reports in detail
Majority of the report is unremarkable or( minimal damage in the form of tendinitis) except for small synovial cyst located in the posterior talofibular joint that may require surgical intervention.
Rest of the abnormalities can be corrected through oral analgesics or anti-inflammatory drugs.
Hope I have answered your query. Let me know if I can assist you further.
Marrow edema will subside in the due course with anti-inflammatory drugs
Yes I refer to this only- 12 x 3 x 2 mm likely ganglion cyst centered within the posterior talofibular ligament.
This cyst requires surgical correction. It has to be removed via surgery.
Marrow oedema and marrow contusion- is minor accompaniment due to mild inflammation (Osteoarthritis) of the involved joint.
Marrow oedema will subside in the due course with anti-inflammatory drugs
Hope I have answered your query.
Dr Suresh Heijebu, General & Family Physician
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