{
 "serie": "s201_STIR_SAG",
 "n_imgs": 18,
 "s": 42.5,
 "respuesta": "**Limited assessment:** These 18 sampled sagittal STIR images are not a complete ankle MRI. Cartilage, individual ankle ligaments, and subtle tendon abnormalities require the remaining sequences and planes.\n\n### Abnormal findings\n\n| Location | Description | Confidence |\n|---|---|---|\n| **Medial tibiotalar articulation** | Focal articular/subchondral irregularity with small bright subchondral foci and mild adjacent marrow signal increase at the medial talar dome and opposing distal tibia, most evident on slices 5–7. Favours localized chronic chondral/subchondral degeneration. A discrete osteochondral defect cannot be reliably delineated on these images. | **Medium** |\n| **Anterior ankle joint margin** | Mild irregularity/spurring of the anterior tibial margin and dorsal talar neck, with adjacent capsular soft-tissue prominence. This may represent residual/recurrent impingement-related change and/or postoperative remodeling; the two cannot be distinguished here. | **Medium** |\n| **Tibiotalar joint fluid** | Small effusion, visible in the anterior and posterior recesses. Mild anterior synovial/capsular thickening is suspected. | **High** for fluid; **medium** for synovial thickening |\n| **Subtalar joint / sinus tarsi–tarsal canal region** | Small posterior subtalar recess fluid collection and prominent irregular fluid-sensitive signal within the sinus tarsi/tarsal canal. The latter may reflect localized fluid and inflammatory change; a discrete ganglion cannot be confirmed from this series alone. | **Medium** |\n| **Pre-Achilles soft tissues / Kager fat pad** | Mild reticular edema-like signal, particularly adjacent to the posterior ankle and subtalar recesses. No organized collection identified. | **Medium** |\n\n### Other structures\n\n- **Bones:** No acute fracture, collapse, or extensive marrow edema identified. Apart from the focal medial articular changes above, marrow signal is relatively preserved.\n- **Cartilage:** Central tibiotalar and posterior subtalar surfaces appear broadly maintained. Subtle or focal cartilage loss cannot be excluded with this sequence.\n- **Tendons:** Achilles tendon is continuous without convincing thickening or intratendinous STIR abnormality. No definite tear of the visualized flexor, extensor, or peroneal tendons. Tendon-sheath disease is not confidently established on these sampled sagittal views.\n- **Ligaments:** The lateral collateral, syndesmotic, and deltoid ligament components are insufficiently depicted to reliably diagnose or exclude chronic sprain or tearing.\n- **Plantar fascia:** No convincing proximal thickening or perifascial edema.\n\n**Overall:** Mild focal medial tibiotalar osteochondral/degenerative change, anterior joint-margin remodeling, and small ankle/subtalar effusions, with additional sinus tarsi and posterior ankle soft-tissue signal abnormality. No definite tendon rupture or acute osseous injury is demonstrated."
}