{
 "serie": "s501_DP_SPAIR_TRA",
 "n_imgs": 24,
 "s": 38.0,
 "respuesta": "**MRI right ankle, axial PD fat-suppressed series only — abnormal findings visible on provided images**\n\n### Bones / marrow / alignment\n- **No focal marrow edema, fracture, or aggressive osseous lesion identified** in the distal tibia, fibula, talus, calcaneus, or visualized midfoot on this series. **Confidence: high**\n- **No definite osteochondral lesion of the talar dome visible on these axial fat-suppressed images.** Cartilage assessment is limited without the full multiplanar study. **Confidence: medium**\n\n### Joints / cartilage / fluid\n- **Tibiotalar joint:** Small-to-moderate joint effusion, most conspicuous in the anterior recess and lateral gutter. Mild associated synovial/pericapsular hyperintensity is possible. **Confidence: high**\n- **Subtalar region / sinus tarsi:** Increased fluid-signal within the sinus tarsi and along the subtalar recesses, suggesting mild subtalar effusion/synovitis or sinus tarsi inflammation. **Confidence: medium**\n- **No clear full-thickness cartilage defect identified** on this sequence. **Confidence: low-to-medium**\n\n### Ligaments\n- **Anterior talofibular ligament region, lateral ankle:** The ATFL is not seen as a normal continuous low-signal band; there is fluid-signal/soft-tissue hyperintensity in the expected course between the distal fibula and talus. Appearance is compatible with chronic high-grade sprain/tear in the setting of remote inversion injury. **Confidence: medium-to-high**\n- **Calcaneofibular ligament:** Not optimally assessed on these axial images; no definite complete disruption is visible, but mild chronic sprain cannot be excluded. **Confidence: low-to-medium**\n- **Syndesmotic ligaments:** Anterior/posterior tibiofibular ligament regions appear grossly preserved on the visible slices. **Confidence: medium**\n- **Deltoid ligament complex:** No definite tear identified on this series. **Confidence: medium**\n\n### Tendons\n- **Flexor hallucis longus tendon sheath / posteromedial hindfoot:** Prominent fluid tracking along the FHL tendon sheath, extending from the posterior ankle toward the plantar-medial hindfoot, compatible with **FHL tenosynovitis**. Tendon itself appears continuous without definite tear. **Confidence: high**\n- **Peroneal tendons, retromalleolar/inframalleolar region:** Small amount of fluid around the peroneal tendons, suggesting mild peroneal tenosynovitis. No definite split tear is visible on these images. **Confidence: medium**\n- **Achilles tendon:** Intact without abnormal thickening or tear on this series. **Confidence: high**\n- **Posterior tibial, flexor digitorum longus, anterior extensor tendons:** Grossly intact where visualized; no definite tear. **Confidence: medium**\n\n### Soft tissues\n- **Mild nonspecific periarticular soft-tissue edema/fluid signal**, greatest around the lateral ankle/sinus tarsi region. **Confidence: medium**\n- No discrete soft-tissue mass or drainable collection identified on the provided sequence. **Confidence: high**\n\n**Key visible abnormalities:** tibiotalar effusion/synovitis, sinus tarsi/subtalar fluid-signal inflammation, chronic-appearing ATFL injury, FHL tenosynovitis, and mild peroneal tenosynovitis."
}