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Prominent Vascular Remnants in the Calcaneus Simulating a Lesion on MRI of the Ankle: Findings in 67 Patients with Cadaveric Correlation

Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.

View larger version (161K): [in a new window]   Fig. 1A —33-year-old male runner with lateral ankle pain. Conventional spin-echo T1-weighted (TR/TE, 500/15) (A) and fast spin-echo T2-weighted (3,000/70) (B) sagittal MR images of ankle show focus of increased T2 (white arrow) and decreased T1 (black arrow) signal within calcaneus in characteristic subtalar location. Lesion measured greater than 5 mm and was considered large.

View larger version (161K): [in a new window]   Fig. 1B —33-year-old male runner with lateral ankle pain. Conventional spin-echo T1-weighted (TR/TE, 500/15) (A) and fast spin-echo T2-weighted (3,000/70) (B) sagittal MR images of ankle show focus of increased T2 (white arrow) and decreased T1 (black arrow) signal within calcaneus in characteristic subtalar location. Lesion measured greater than 5 mm and was considered large.

View larger version (180K): [in a new window]   Fig. 2A —18-year-old male basketball player with history of multiple ankle sprains. Fast spin-echo T2-weighted (TR/TE, 4,000/70) sagittal (A), axial (B), and coronal (C) MR images of ankle show medium-sized focal signal abnormality (white arrow, A) within calcaneus.

View larger version (114K): [in a new window]   Fig. 2B —18-year-old male basketball player with history of multiple ankle sprains. Fast spin-echo T2-weighted (TR/TE, 4,000/70) sagittal (A), axial (B), and coronal (C) MR images of ankle show medium-sized focal signal abnormality (white arrow, A) within calcaneus.

View larger version (161K): [in a new window]   Fig. 2C —18-year-old male basketball player with history of multiple ankle sprains. Fast spin-echo T2-weighted (TR/TE, 4,000/70) sagittal (A), axial (B), and coronal (C) MR images of ankle show medium-sized focal signal abnormality (white arrow, A) within calcaneus.

View larger version (149K): [in a new window]   Fig. 3 —16-year-old female volleyball player with chronic ankle pain. Fast spin-echo T2-weighted (TR/TE, 4,000/70) sagittal MR image of ankle shows small-sized focal signal abnormality (white arrow) within calcaneus.

View larger version (147K): [in a new window]   Fig. 4A —Histologic examination of cadaveric specimens. Sagittal fast spin-echo T2-weighted (TR/TE, 4,000/67.3) MR image (A) through cadaveric calcaneus shows medium-sized focal subtalar signal abnormality (arrow), with corresponding gross specimen (B) and histologic correlates (C). Arrows show corresponding dilated vascular channels within histopathologic section.

View larger version (180K): [in a new window]   Fig. 4B —Histologic examination of cadaveric specimens. Sagittal fast spin-echo T2-weighted (TR/TE, 4,000/67.3) MR image (A) through cadaveric calcaneus shows medium-sized focal subtalar signal abnormality (arrow), with corresponding gross specimen (B) and histologic correlates (C). Arrows show corresponding dilated vascular channels within histopathologic section.

View larger version (175K): [in a new window]   Fig. 4C —Histologic examination of cadaveric specimens. Sagittal fast spin-echo T2-weighted (TR/TE, 4,000/67.3) MR image (A) through cadaveric calcaneus shows medium-sized focal subtalar signal abnormality (arrow), with corresponding gross specimen (B) and histologic correlates (C). Arrows show corresponding dilated vascular channels within histopathologic section.

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