{
 "serie": "s701_DP_SPAIR_COR",
 "n_imgs": 24,
 "s": 40.0,
 "respuesta": "**Series:** Coronal PD SPAIR (fat‑suppressed, fluid‑sensitive), right ankle, anterior → posterior.\n\n**Findings**\n\n1. **Calcaneus – bone marrow edema (medium confidence).** On the posterior slices (approx. images 13–19) there is a thick, crescentic band of high signal within the calcaneal body hugging the plantar and posterolateral cortex, with relatively preserved dark marrow centrally. This pattern is most consistent with calcaneal marrow edema (contusion / early stress injury of the posterior tuberosity–plantar cortex). No discrete linear fracture cleft is definitely resolved at this sampling. Caveat: the heel lies at the periphery of the field of view and the most posterior slices (20–24) show generalized inhomogeneous fat suppression, so some of this signal may be technical; correlation with a non‑fat‑suppressed sequence is required.\n\n2. **Sinus tarsi / lateral hindfoot – fluid/edema signal (medium confidence).** On mid‑coronal slices (≈ images 8–12) the sinus tarsi and lateral hindfoot show irregular hyperintense signal replacing the normally suppressed fat, suggesting sinus tarsi edema/synovitis (possibly post‑inversion injury). Interosseous talocalcaneal ligament fibers are not clearly defined.\n\n3. **Tibiotalar joint – small effusion (medium confidence).** Thin high‑signal fluid line along the tibial plafond and in the medial and lateral gutters (images 8–11). No large effusion.\n\n4. **Talar dome – subchondral signal change (low confidence).** Faint ill‑defined high signal in the talar dome beneath the plafond (images 9–11), possibly mild subchondral edema/contusion; no clear osteochondral defect or cartilage flap identified.\n\n5. **Anterior ankle soft tissues – edema / mild tenosynovitis (low confidence).** On anterior slices (images 5–7) there is increased signal in the anterior soft tissues around the extensor tendons/anterior capsule, which could represent subcutaneous edema or mild extensor tenosynovitis.\n\n**Structures appearing normal**\n- Distal tibia and fibula marrow: no edema; no fracture line.\n- Achilles tendon: normal thickness and uniformly low signal on posterior slices; no retrocalcaneal bursal distension of significance.\n- Medial flexor tendons (posterior tibial, FDL, FHL) and peroneal tendons: normal caliber, no significant tendon sheath fluid identified on the sampled images.\n- Deltoid ligament (deep fibers) appears intact on medial slices; lateral ligaments not optimally assessed in the coronal plane.\n- Talonavicular and subtalar joints: no gross malalignment.\n\n**Impression**\nCrescentic calcaneal marrow edema (probable contusion/stress injury; exclude technical fat‑sat inhomogeneity), sinus tarsi edema, and a small tibiotalar effusion, with possible mild talar dome subchondral edema – overall pattern suggestive of a hindfoot injury (e.g., inversion/impaction mechanism). Correlate with non‑fat‑suppressed and axial/sagittal sequences for a fracture line and ligament assessment."
}