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Anteromedial Impingement of the Ankle

Using MR Arthrography to Assess the Anteromedial Recess

P. Robinson1,2, L. M. White1, D. Salonen1 and D. Ogilvie-Harris3

1 Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, University of Toronto, Toronto, Ontario, Canada M5S 1A1.
2 Present address: Department of Diagnostic Radiology, St. James University Hospital, Beckett St., Leeds, LS9 7TF, United Kingdom.
3 Department of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada M5S 1A1.



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  		Fig. 1A. —18-year-old man with anteromedial impingement diagnosed clinically. Axial proton density—weighted fast spin-echo MR image (TR/TE, 3,967/32; echo-train length, 12) of right ankle shows large nodular soft-tissue mass (arrows) adherent to medial malleolus.

 


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  		Fig. 1B. —18-year-old man with anteromedial impingement diagnosed clinically. Sagittal T2-weighted fat-suppressed, fast spin-echo MR image (3,933/ 80; echo-train length, 8) at medial aspect of tibiotalar joint shows nodular contour (arrow) to anteromedial capsule.

 


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  		Fig. 2A. —28-year-old woman with anteromedial impingement diagnosed clinically. Axial proton density—weighted fast spin-echo MR image (TR/TE, 3,967/32; echo-train length, 12) of left ankle shows intact tibiotalar ligament (asterisk) with anterior and medial synovial thickening (arrow).

 


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  		Fig. 2B. —28-year-old woman with anteromedial impingement diagnosed clinically. Sagittal T1-weighted fat-suppressed conventional spin-echo MR image (583/8) at medial aspect of tibiotalar joint shows anteromedial tibial (white arrow) and talar (black arrow) osteophytes.

 


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  		Fig. 3. —31-year-old woman with mild lateral instability diagnosed clinically. Axial proton density—weighted fast spin-echo MR image (TR/TE, 3,967/32; echo-train length, 12) of right ankle shows smooth outline to anteromedial capsular tissues (arrows).

 


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  		Fig. 4. —26-year-old man with medial talar osteochondral defect diagnosed clinically. Sagittal T2-weighted fat-suppressed, fast spin-echo MR image (TR/TE, 3,933/80; echo-train length, 8) at medial aspect of right tibiotalar joint shows smooth contour to anteromedial capsule (arrows).

 

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