FINDINGS:

Bones: There is a large osteochondral lesion involving the medial talar dome with associated subchondral bone marrow edema and cystic change. There is a small subchondral fracture line. There is a small ossicle adjacent to the anterior process of the calcaneus, consistent with an os trigonum. There is no evidence of acute fracture. There is no significant joint effusion. Ligaments: The anterior and posterior tibiofibular ligaments are intact. The anterior and posterior talofibular ligaments are intact. The calcaneofibular ligament is intact. The deltoid ligament is intact. Tendons: The flexor, extensor, peroneal, and Achilles tendons are intact. Muscles: The visualized muscles are normal in appearance. Soft tissues: The subcutaneous tissues are normal in appearance. IMPRESSION:

1. Large osteochondral lesion of the medial talar dome with associated subchondral bone marrow edema and cystic change. 2. Small subchondral fracture line of the medial talar dome. 3. Small os trigonum. 4. No evidence of acute ligamentous injury. 5. No evidence of acute fracture. 6. No significant joint effusion.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6. No acute tendon tear. 7. No significant soft tissue swelling. 8. No discrete soft tissue mass.

1. Chronic sprain of the anterior talofibular ligament. 2. No acute fracture or dislocation. 3. No osteochondral lesion of the talar dome. 4. No plantar fasciitis. 5. No Achilles tendinopathy. 6