Large ankle and posterior subtalar joint effusions. Further small talonavicular joint effusion.
There is an undisplaced fracture through the posterior malleolus of the tibia involving the insertion of the posterior inferior syndesmotic ligament, which itself is heterogeneously hyperintense but intact. There is an avulsion fracture of the tip of the lateral malleolus involving the anterior talofibular ligament insertion; the anterior talofibular ligament is intact but hypointense and thickened suggesting previous injury. There is a full thickness rupture of the calcaneofibular ligament. There is a further undisplaced fracture of the medial malleolus with grade 2 sprain injury of the deltoid ligament. There is bone marrow oedema with associated T1 hypointensity of the anteromedial talar dome in keeping with an osteochondral injury with subchondral fracture.
Anterior inferior syndesmotic ligament is completely ruptured. Hyperintensity of the interosseous ligament. Heterogeneity of an intact posterior talofibular ligament in keeping with a low-grade injury.
Dorsal talonavicular ligament is intact. Spring ligament is intact.
Mild hyperintensity of the sinus tarsi. Normal plantar fascia and Achilles tendon.
Anterior/extension tendons are intact. There is an effusion of the common peroneal tendon sheath with mild hyperintensity at the distal myotendinous junction of peroneus longus in keeping with a low-grade strain injury. Peroneal tendons are intact. Tendon sheath effusions of the posterior/flexor tendons, however, the tendons appear intact.