{
 "serie": "s601_T1W_aTSE",
 "n_imgs": 24,
 "s": 37.4,
 "respuesta": "**Limited assessment:** These are sampled coronal T1-weighted images only. Marrow edema, cartilage defects, ligament tears, and small amounts of fluid cannot be reliably assessed without the other sequences.\n\n### Abnormal findings\n\n| Location | Description | Confidence |\n|---|---|---|\n| **Medial subtalar joint, at the middle talocalcaneal facet/sustentaculum tali** | The articulation appears narrowed and irregular, with indistinct opposing cortical margins, adjacent low-T1 subchondral signal, and mild bony remodeling. This is **suspicious for a nonosseous talocalcaneal coalition**, with associated reactive/degenerative change. Definite continuous marrow bridging is not demonstrated. Focal subtalar arthropathy is an alternative explanation. | **Medium** |\n\n### Other structures\n- **Bones:** No definite fracture, osteonecrosis, or displaced osteochondral fragment. No convincing focal talar-dome osteochondral defect on these images.\n- **Cartilage/joints:** Tibiotalar joint space and the posterior subtalar articulation are relatively preserved. Focal cartilage injury cannot be excluded on this sequence.\n- **Ligaments:** No definite ligament discontinuity is demonstrated. The lateral ligament complex and syndesmotic ligaments are not adequately characterized in this plane; a chronic sprain cannot be reliably confirmed or excluded.\n- **Tendons:** Visualized tendon portions, including the Achilles tendon, show no gross tear. The peroneal and medial flexor tendons require axial images for reliable assessment.\n- **Joint fluid:** No large ankle or subtalar effusion.\n- **Soft tissues:** No discrete mass, collection, or marked swelling identified.\n\n**Impression:** Suspected middle-facet talocalcaneal coalition with localized reactive/degenerative changes. Confirmation requires review of the full multiplanar MRI, particularly fluid-sensitive images; CT may help characterize the bony anatomy if needed."
}