{
 "serie": "s601_T1W_aTSE",
 "n_imgs": 24,
 "s": 45.8,
 "respuesta": "**Series / technique:** Coronal T1-weighted TSE of the right ankle, 24 representative slices ordered from anterior (talar head/navicular) to posterior (Achilles/calcaneal tuberosity). T1 only – fluid-sensitive sequences are not available, so marrow oedema, effusion and ligament oedema cannot be confidently assessed.\n\n**Findings**\n\n1. **Anterolateral tibiotalar gutter – soft tissue thickening/scar (medium confidence)**\n Slices 7–9 (anterior half of the tibiotalar joint): the lateral gutter between the lateral talar dome/anterolateral tibial plafond and the medial fibular surface contains irregular intermediate-to-low T1 signal tissue replacing the normal thin joint recess. In the context of prior arthroscopic osteophyte resection and previous sprain, this is most consistent with post-surgical/post-traumatic anterolateral gutter scarring (soft-tissue impingement pattern). Cannot exclude synovitis without fluid-sensitive/contrast images.\n\n2. **Lateral tibiotalar joint – subtle osteochondral irregularity (low–medium confidence)**\n Slices 8–9: a small focus of low T1 signal at the lateral corner of the joint (anterolateral tibial plafond / lateral talar dome margin) with slight cortical irregularity. Could represent a small subchondral cyst/sclerosis or post-resection contour irregularity rather than a true osteochondral lesion. Correlation with PD-FS/T2 sequences recommended.\n\n3. **Anterior distal tibia – minor residual/recurrent anterior lip irregularity (low confidence)**\n Slices 6–8: the anterior tibial margin appears mildly irregular, in keeping with previous osteophyte resection; no large recurrent anterior osteophyte convincingly identified on these coronal images.\n\n4. **Lateral ligaments (ATFL/CFL region) – probable chronic thickening (low confidence)**\n Slices 9–12: the tissue at the fibular tip extending toward the lateral talus/calcaneus is somewhat thickened and of intermediate signal, compatible with chronic scarring of the lateral ligament complex after remote sprain. Coronal T1 is suboptimal for ATFL assessment; no gross discontinuity seen.\n\n5. **Small focal low-signal dot in the superior calcaneus (slice 15) – likely vascular channel/tiny cyst, insignificant (low confidence).**\n\n**Structures appearing normal on this sequence**\n- Talar body, calcaneus, navicular, distal tibia and fibula marrow: homogeneous fatty T1 signal, no marrow-replacing lesion, no fracture line.\n- Medial malleolus and deltoid ligament region: unremarkable.\n- Sinus tarsi: fat preserved, interosseous ligament intact.\n- Posterior subtalar joint: congruent, no obvious erosion.\n- Medial flexor tendons (TP, FDL, FHL) and peroneal tendons: normal calibre and low signal, no split or tenosynovial mass appreciated (fluid not assessable on T1).\n- Achilles tendon: normal thickness and signal; Kager fat pad clear.\n- Plantar fascia and plantar intrinsic muscles: normal.\n- No significant tibiotalar effusion appreciable (limited on T1).\n\n**Impression**\nPost-arthroscopy right ankle with anterolateral gutter soft-tissue scarring (probable anterolateral impingement) and subtle lateral tibiotalar subchondral/marginal irregularity; probable chronic lateral ligament thickening. No marrow lesion, fracture or tendon tear identified. Recommend review of fluid-sensitive sequences (PD/T2 FS, sagittal/axial) to characterise effusion, marrow oedema and cartilage status."
}