Conclusion: Results: Take this Is My Ankle Broken quiz to find out. Bone bruises are common after severe ankle sprain. Bone contusions were diagnosed in 71 cases (27.8%); 55 (22.5%) were identified as single contusions and 16 (6.3%) as kissing contusions. The .gov means its official. Local autograft was then supplemented with an allograft demineralized bone graft substitute. However an intraosseous bleed cannot be picked up on an X-ray. Also, displaced intra-articular loose National Library of Medicine Two exostoses were noted to be extending posteriorly from the talus and calcaneus, respectively. The mass extended from the talus to the calcaneus. The symptoms are pain that is severe and felt in the upper thigh without any history of injury or trauma. This type of bleeding is commonly diagnosed as a bone bruise. Radiological investigations are very useful in detecting the cause of the bone bruise. ankle inversion and dorsiflexion during axial load creates shearing of lateral talar dome and lateral OLT, ankle inversion, external rotation, and plantarflexion during axial load creates shearing of medial talar dome and medial OLT, possible repeitive microtrauma creates ischemic environment and loss of integrity of subchondral bone, leads to softening and disruption of overlying cartilage, among the thickest in the body (implications for osteochondral autografting), maintains tensile strength longer than femoral head with aging process, deltoid artery supplies majority of talar body and dome, ankle is a highly congruent mortise joint, oriented 15 degrees externally from midsagittal line of ankle, talus articulates with the medial malleolus medially, tibial plafond superiorly, posterior malleolus posteriorly, and fibula laterally, Berndt and Harty Radiographic Classification, Complete fragment detachment but not displaced, Cystic lesion within dome of talus with an intact roof on all view, Cystic lesion communication to talar dome surface, Open articular surface lesion with the overlying nondisplaced fragment, Cartilage injury with underlying fracture and surrounding bony edema, mechanical symptoms such as catching or locking, often limited secondary to pain or effusion, evaluate for ligamentous laxity or insufficiency, suspicion for OLT in setting of equivocal radiographs, helpful in evaluating subchondral bone and cysts, less reliable in purely cartilaginous lesions of nondisplaced OLTs, provides fine detail of lesions for pre-operative planning, persistent pain following injury, ankle sprains that do not heal with time, variable edema patterns, may overestimate degree of injury, unstable lesions show fluid deep to subchondral bone, predicts stability of lesion with 92% sensitivity, nondisplaced fragment with incomplete fracture, osteochondral grafting (osteochondral autograft transplantation, autologous chondrocyte implantation, bulk allograft), size > 1 cm and displaced lesions, shoulder lesions, salvage for failed marrow stimulation or drilling, period of immobilization in cast or boot for 6 weeks, followed by progressive weight bearing with physical therapy emphasizing peroneal strengthening, range of motion, and proprioceptive training, debridement of unstable cartilage flaps to create stable and contained defect using curettes or shaver, loose bodies and cartilage removed using shaver or grasper, microfracture awl placed perpendicular to surface and tapped into subchondral bone 2-4 mm deep, inflow stopped to allow fat or blood to emanate from holes, indicating adequate penetration, Kirschner wire can be passed using anterior portals, or transmalleolar for central or posterior lesions, talus dorsiflexed and plantar flex to necessitate only 1 transosseous passing of wire, articular cartilage delamination and graft failure, 65-90% improvement in patient reported outcomes, fibrocartilage formation at site of lesion in 60% of patients on second-look arthroscopy, no correlation noted with patient outcomes, evaluate cartilaginous surface for softening, dimpling with probe seen, Kirschner wire drilled from sinus tarsi into defect, fluoroscopy often helpful to confirm location, if bone grafting indicated, cannulated drill placed over K wire, dictated by location of OLT and concomitant procedures required (i.e. Popping sensation or sound at the time of injury. Femoral Bone Contusions & Stretching. In three (table 2, cases 8, 10, and 11) the kissing contusion appeared in the lateral compart-ment, with a type II lesion on the femoral condyle and a type I lesion on the tibial condyle. In this case the patient had symptomatic peroneal compression and subtalar arthrosis. More to Know A contusion, or bruise, forms when soft tissue in the body is crushed but the skin doesn't break. Considering her chronic persistent pain, Kissing Carotids. Schematic drawing of talocrural joint injury in pronation (a) results in sprain of the medial collateral ligaments (brown) and lateral-sided OCL of the talar dome and/or kissing tibial lesion (orange zones), whereas injury in supination (b) causes sprain of the lateral ligaments and medial-sided OCL of the talar Severe locking or catching symptoms, where the ankle freezes up and will not bend, may indicate that there is a large osteochondral lesion or even a loose piece of cartilage or free bone within the joint. Foot Ankle Int 2009;30(9):836841.4. Type of Sprained Ankle: Understand How Ankles Get Sprained. Basketball is a popular sport in North America and worldwide. Cover it with a towel and place it on your foot for 15 to 20 minutes every hour or as directed. Bone contusions in both surfaces of the knee (kissing contusion) are rather rare complex injuries of the knee and their importance has not been well established. To our knowledge, no detailed studies exist on bone bruises associated with osteochondral fractures in the ankle. When compared to medial talar OCDs, which of the following statements is true regarding lateral talar OCDs? These characteristic lesions that occur both on the femoral and tibial condyle are of great importance, not only in that they are frequently a sign of more serious associated injury . Our case report is important as it is the first description of these MRI findings which will help enable clinicians to recognise this rare injury and allow for appropriate management. Heres the bottom line: bone bruises require more care than simple black and blue marks on the surface of your skin. This type of fracture involves the cartilage and takes few years to completely heal. The authors declare that there is no conflict of interest regarding the publication of this manuscript, Ahmed AR, Tan TS, Unni KK, Collins MS, Wenger DE, Sim FH. subchondral bone contusions, fractures, and kissing lesions of the talotibial joint after a sprain of the ankle shown on MR imaging. Histopathology revealed cartilaginous island with an active chondrocyte surrounded by osteoid matrix of the attached bony stalk. A contusion, or bruise, forms when soft tissue in the body is crushed but the skin doesn't break. This is common in older females when there is existing bone weakness due to osteoporosis. Figures A and B are radiographs of the left ankle. A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. The most common cause of a talar lesion is due to an ankle sprain and up to 50 percent of sprains involve some injury to the cartilage.1-3Two common lesions are notable on the talus. Women Rain Boots Ankle Short Chelsea Rubber Elastic Solid Waterproof Anti-slip Shoes Booties dripdrop ladies low. Ankle impingement is a common condition occurring secondary to sprain or repeated microtrauma. T1 weighted method of MRI will show the bruise in the form of a decrease in bone intensity. Large para-articular osteochondroma of the knee joint: a case report. We retrospectively reviewed the images of all consecutive patients who underwent MR imaging of the ankle after acute or recurrent sprain occurring between January and December 1997. Most of these lesions present with innocuous swelling or pain, sometimes with movement restriction or mechanical compression. A 58-year-old female administrator presented with persistent pain at her left hindfoot. Iliac bone and pubic bone after a blunt injury to the pelvic region. What is a bone bruise? . Clin Orthop 2003 ; 411 : 193-206. Consider these drawings of the lateral view of the ankle, showing, left to right, normal alignment; a tibio-talar subluxation and then a tibio-talar dislocation: And now think about the structural damage: with a dislocation, there could be a bone contusion where there is abnormal contact (shown below as the green "kissing contusion"); and the . On this Wikipedia the language links are at the top of the page across from the article title. Rebecca Herbst originally auditioned for the role of Sarah Webber.Although she did not get the part, General Hospital created the role of Sarah's sister, Elizabeth for Herbst to play, and she debuted on August 1, 1997. The number and location of subchondral contusions or fractures revealed on MR imaging were recorded, and a comparison was made with the radiographs obtained for each patient. A strain is an injury to a muscle or to a tendon (tissue that connects muscle to bone). This happens when the ankle rolls so that the sole of the foot is facing inward. However, for the last six months, he has developed persistent ankle pain with intermittent swelling. If you have bumped your foot and the swelling and tenderness arent going away, its a good idea to get into your doctors office for an immediate evaluation. This takes only a few months. A common symptom of ankle instability is the feeling of the ankle ready to give way. Symptoms of a Calf contusion include: Instant pain following a direct blow or impact. The bruise does not reach the surface of the joint and is generally mild in intensity. Magnetic resonance imaging characterization of individual ankle syndesmosis structures in asymptomatic and surgically treated cohorts $28.90 $ 28. Finally, physical therapy may help you learn to move in ways that wont aggravate your injuryask your doctor if this is relevant in your specific situation. Given the advanced nature of the lesion and failure of nonoperative modalities, surgical intervention was proposed. kissing contusion ankle Best Selling Author and International Speaker. Radiographs are unremarkable. You may be told to keep your foot wrapped with a tight elastic bandage. Physical exam reveals some joint swelling but no ligamentous instability. Kissing corns are soft corns that form between your toes, usually the fourth and fifth. of and in " a to was is ) ( for as on by he with 's that at from his it an were are which this also be has or : had first one their its new after but who not they have The incidence has been reported to be between 2 and 7 per 1000 person-years. Foot: Bone marrow oedema in the ankle and the foot can occur in young individuals and give rise to pain in the foot or the ankle without any identifiable cause. Advertisement. 1997;5(2):113-7. doi: 10.1007/s001670050036. Osteochondroma comprise the most common benign bone tumor and their overall incidence is unknown as many are asymptomatic and only detected once their mass effect manifests as a cosmetic deformity, mechanical symptom or symptom of neurovascular compression [2, 3]. (OBQ06.213) Deep Bone Bruise is an injury and bleed in the medullary part of the bone and hence it is classified as intraosseous bleed. An ankle fusion can often last a lifetime compared to an ankle replacement, which tends to have a higher failure rate. The mass extended from the talus to the calcaneus. For instance, if the anterior cruciate ligament were to rupture, the tibia can slide forward (subluxate) and impact the femoral condyle (a so-called kissing contusion). (, Chou LB, Ho YY, Malawer MM. Pain Physician. The reciprocal bone bruising of the navicular and medial cuneiform on MRI, also known as the kissing sign, is unique and signifies acute instability of the first ray. (, Marco RA, Gitelis S, Brebach GT, Healey JH. A narrow osteotome was used to increase the exposed cancellous surface area. A 21-year-old male reports right ankle pain after sustaining an inversion ankle injury 2 years ago. Kissing contusions are rare (16/225 (6.3%)) but studies. It is sometimes called a "pulled muscle.". LeBron James will be out indefinitely after suffering a high ankle sprain on Saturday as the Los Angeles Lakers took on the Atlanta Hawks. (ii)Geographic: This type of bone bruise is comparatively bigger in size and more dense as compared to reticular bruise. (a)The affected leg or part which has suffered the injury should be kept elevated and immobile to prevent further damage. A: Yes. Foot was approved as part of Unicode 11.0 in 2018 and added to Emoji 11.0 in 2018.. re-rupture. if(typeof ez_ad_units != 'undefined'){ez_ad_units.push([[300,250],'hxbenefit_com-banner-1','ezslot_8',149,'0','0'])};__ez_fad_position('div-gpt-ad-hxbenefit_com-banner-1-0');Treatment is primarily rest and elevation of affected leg. Seo SS, Park JY, Kim HJ, Yoon JW, Park SH, Kim KH. At six month and one year follow up visits the patient had returned to full activities without difficulty or pain at her left hindfoot. Bone Bruise is a condition where the cortical part of the bone is intact and the inner medullary part is broken. A contusion is a tern usually applied to soft tissue injuries that involve numerous structures. Diagnosis by an X-ray is often difficult and higher investigations like MRI may be required. Contusions of both surfaces of the knee joint are known as kissing contusions. . The differential diagnosis of bone bruise are-. Rausch V, Knigshausen M, Schildhauer TA, Gessmann J, Seybold D. Obere Extrem. Orthop J Sports Med. This was demonstrated in our patient who had subtalar arthrosis adjacent to peri-articular talar and calcaneal osteochondroma. Restricted range of motion. Epub 2002 Sep 21. There is also a bone contusion at the postlateral aspect of the head of talus with localised subcortial "kissing" contusion at postlateral aspect of the distal tibia. Types of Foot and Ankle Ligament Surgeries. Its also wise to see your podiatrist since he or she will perform an X-ray to confirm whether the bone is simply bruised, or if a fracture has occurred. Complication associated with subperiosteal haematoma is calcification of the blood clot and formation of bone tissue around it. PMC The time taken by the individual to get back to normal activities is called as recovery time. Cartilage Tumors: Evaluation and Treatment. Figure C shows the corresponding MRI. Dorsal talonavicular ligament is intact. We hope understanding the chronic complications associated with these lesions can facilitate earlier management prior to the development of late arthritic changes. doi: 10.3827/faoj.2017.1003.0002, 1 San Antonio Military Medical Center (SAMMC) in San Antonio, Texas, United States. "The appearance of kissing contusion in the acutely injured knee in the athletes", https://en.wikipedia.org/w/index.php?title=Kissing_contusion&oldid=903873252, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 28 June 2019, at 13:40. Approximately 2mm of subchondral bone was removed. Hip: The commonest cause of oedema in the hip bone is avascular necrosis of the neck of femur. Instability in the ankle. In knee joint bone bruises, this time is upto two months whereas ankle bruises may take even twelve months to completely go away. Treatment for a sprained ankle depends on the severity of your injury. The vision trouble increases with each passing day. . Pathology can range from a simple contusion of the articular cartilage and subchondral bone to a fracture involving the cartilage alone or cartilage and underlying subchondral bone together. Contusion of left ankle, initial encounter. This is more common after a geographic bruise. kissing contusion ankle. hamstring, stress fracture, ankle, herniated disc, bruise, more. Lateral view of the left ankle demonstrating postoperative changes with removal of the talocalcaneal osteochondromas and subtalar arthrodesis. Bone bruises detected by magnetic resonance imaging following lateral ankle sprains. An ankle X-ray can detect broken bones, assist a physician in setting the broken bone, and can monitor the treatment process to determine whether the bone is properly aligned and the break is healing properly. There are some medical conditions which present with similar symptoms as bone bruise. Magnetic resonance imaging demonstrated bony excrescences at the posterior subtalar joint with disruption of the posterior facet articular surfaces. Shown on Apple platforms as the sole of a foot. Injury Report: 04/18/21 08:30 PM Game Date Game Time Matchup Team Player Name Current Status Reason Ankle X-rays are used in pre-surgical planning and are used post-surgery to assess the results of the surgery. A contusion may involve nerve, subcutaneous tissue, tendon, etc. (c)Types of Bone Bruises Based on MRI Findings. Of the 146 ankles, 42 osteochondral lesions were revealed on MR imaging in 26 ankles (18%) involving 23 patients. Copyright 2023 Lineage Medical, Inc. All rights reserved. A contusion may involve nerve, subcutaneous tissue, tendon, etc. eCollection 2021 Nov. Allahabadi S, Allahabadi S, Allala R, Garg K, Pandya NK, Lau BC. Long-term osseous sequelae after acute trauma of the knee joint evaluated by MRI. (, Herrera-Perez M, De Mendoza M, De Bergua-Domingo J, Pais-Brito J. Osteochondromas around the ankle: Report of a case and literature review; International Journal of Surgery Case Reports 4 (2013) 1025 1027. June 7, 2022; certified financial therapist . Total contact cast immobilization and nonweight-bearing for 6 weeks. (, Wuisman PIJ, Jutte PC, Ozaki T. Secondary chondrosarcoma in osteochondromas: Medullary extension in 15 of 45 cases. Disclaimer. A contusion is a term usually applied to soft tissue injuries that involve numerous structures. This site needs JavaScript to work properly. There was also underlying severe bone on bone degenerative change of the posterior facet with associated reactive edema within the talus and calcaneus (Figure 2). SZA was never going to let an injury put a damper on her night at the Grammys but it turns out a pre-show mishap was more serious than she thought. Marrow continuity between talus/calcaneus and their respective prominences was consistent with a presumptive diagnosis of osteochondroma. Similar findings, referred to as "kissing" contusions, have also been described in the knee [ 7 ]. Osteochondral Lesions of the Tibial Plafond: A Systematic Review. At six month and one year follow up visits the patient had returned to full activities without difficulty or pain at her left hindfoot. A contusion usually can be distinguished from a muscle rupture, because residual function remains after a contusion. Takao M, Ochi M, Naito K, Uchio Y, Kono T, Oae K. Arthroscopy. Osteochondroma of the talus. you spoke with Raimer? 604 Trauma to the skin, subcutaneous tissue and breast with mcc; 605 Trauma to the skin, subcutaneous tissue and breast without mcc; 963 Other multiple significant trauma with mcc; An ankle X-ray can detect broken bones, assist a physician in setting the broken bone, and can monitor the treatment process to determine whether the bone is properly aligned and the break is healing properly. maroondah council open space contribution A contusion, or bruise, forms when soft tissue in the body is crushed but the skin doesn't break. This case highlights how careful surgical planning can appropriately evaluate for any malignant transformation while preventing the recurrence of this lesion and mitigating its complications. The healing time is measured as the time taken for the bone bruise to completely disappear. kissing contusion ankle. Objective: The objective of this study was to determine the presence and location of subchondral bone contusions, fractures, and "kissing" lesions of the talotibial joint after a sprain of the ankle shown on MR imaging. Osteochondral Fracture: If the hairline bone fracture affects the cartilage and forms a connection between the joint and the bone bruise then it is diagnosed as an osteochondral fracture. Symptoms are skin bruises and bulging anywhere in the scalp region due to collection of blood beneath the bone. They are associated with joint pain and inflammation. Thus she underwent excision of osteochondroma and subsequent subtalar fusion. Osteochondromas have been reported in the literature adjacent to a periosteal chondroma forming a kissing lesion [7]. Ankle sprains are a common cause of OLTs. The mass was identified deep to the FHL with its enveloping bursa (Figure 3). In some cases, that loss of blood flow can allow portions of your bone to die, making any damage incurred permanent and irreversible. Figure 4 Removal of the osteochondromas about the posterior aspect of the subtalar joint with demonstration of exposed subchondral bone. Hi woud appreciate any opinons on this. by Christopher Gaunder MD, Brandon McKinney DO*, Joseph Alderete MD, Thomas Dowd MD, The Foot and Ankle Online Journal 10 (3): 2. The cartilage can be torn, crushed or damaged and, in rare cases, a cyst can form in the cartilage. Last Reviewed: Jan 19th, 2023, Extracoporeal Pulse Activation Therapy (EPAT), Laser/PinPointe Laser Treatment for Fungal Nails. This time is usually shorter than healing time. It is common to hear a snapping or popping sound when one of the bodys joints is injured. No calcaneocuboid joint effusion. S80.02XA is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Clarke, just before the end of the first quarter of their game against the Denver Nuggets at Ball Arena, missed a free throw and took a step back with his left leg. However, Trevors disease (Dysplasia Epiphysealis Hemimelica or DEH) or Fairbanks disease are variants of osteochondromata in which the lesion is intra-articular and grows adjacent to joint cartilage [8]. When identified in a child, conservative management of these uniquely paired osteochondromas or periosteal chondroma is usually advocated, as surgical intervention for asymptomatic, intra-articular lesions may result in secondary arthrosis. Wrist and joints of the hand are involved before the patient tests positive for rheumatoid factor. A condition where the blood collects inbetween the cortical bone and the periosteum is called as subperiosteal haematoma. Sagittal T2-weighted image 1 year after injury reveals a subchondral cyst (arrow), an articular defect in the lateral tibial plateau, and a large knee effusion (arrowhead). Kissing contusion type marrow edema at the medial malleolus and medial talar neck with contusion of the anterior to mid deep deltoid fibers. Osteochondromas are benign bone lesions derived from aberrant cartilage. The coronal image demonstrates the extensive osteoarthritic changes apparent in the subtalar joint of the patient. It does this because it wants it to heal and so all the weight shifts to the ankle. 6. Prognosis: After a knee joint bone bruise, the recovery time for atheletes is usually 6 months especially if the anterior cruciate ligament is torn. re-rupture. Other examples of bone injuries include stress fractures, osteochondral fractures and a variety of different patterns of bone fractures. Pain, deformities, and the grinding or movement of broken bones of the knee, shin, ankle, and foot. from publication: The appearance of kissing contusion in the acutely injured knee in the athletes | Bone contusions are often identified at magnetic resonance imaging (MRI) in the acutely. These changes are seen in MRI and are diagnosed as reactive oedema of the bone marrow. In four of the 16 cases (25%), the kissing contusion was found as an isolated lesion. The clot will resolve on its own but if the size is big and it fails to get reabsorbed, then surgical removal of the clot has to be done. Unsuspected post-traumatic chondral, or osteochondral fractures may be seen. Posttraumatic subchondral bone contusions and fractures of the talotibial joint: occurrence of kissing lesions. Single bone contusions are seen more often impacting on one another during an avulsion injury. The symptoms of a bone contusion include: stiffness or swelling tenderness trouble bending or using the affected area pain that lasts longer than the symptoms of a typical bruise would Bone. In children, most toe, foot, or ankle injuries occur during sports, play, or falls. A T2 weighted scan or a fat suppressed type of MRI will show increased intensity. Symptoms of a strain are pain, swelling, and having a problem moving or using the injured area. Conclusions: Kissing contusion is a significant injury often associated with ligamentous or menisceal injuries. The common sites where these bruises are seen are: Bone bruises are common in the ankle region especially in the lower ends of the tibia or the talus bone. The weight of the body falls on the ankle joint and leads to a bruise which can take upto 3 months to heal. Osteochondral Lesions of the Distal Tibial Plafond: A Systematic Review of Lesion Locations and Treatment Outcomes. They comprise 30 to 50% of benign bone lesion diagnoses and 15% of all bone tumors. * Corresponding author: bmckinney@westernu.edu. Unsuspected post-traumatic chondral, or osteochondral fractures may be seen. Skin has bruises which are not due to bleeding beneath the skin but a result of internal bleeding in the bone. Keeping the knee in a slight bend (approximately 30 degrees), start the tape at the level of the lower leg anchor on the inner aspect of the knee by following the black arrows (figure 2). Kissing contusion Contusions of both surfaces of the knee joint are known as kissing contusions. One thing that will certainly be a talking point if LeBrons injury is serious is Solomon Hills role. Traumatic injury to the ankle/foot (ankle sprain) or overuse is the main cause of this syndrome. In 16 (11%) of the 146 ankles, the lesions were present in the opposing bones of the joint ("kissing" lesions). associated with age . In some cases, there is avascular necrosis of the bone as the blood supply to the bone is affected. Arthroscopy 1. Baldassarri M, Perazzo L, Ricciarelli M, Natali S, Vannini F, Buda R. Eur J Orthop Surg Traumatol. Symptoms of posterior Impingement. Use an ice pack, or put crushed ice in a plastic bag. 2003 May-Jun;19(5):524-30. doi: 10.1053/jars.2003.50111. The Achilles tendon was split longitudinally and retracted. If the bruise has occurred around a joint, like that at your toe, you may need to immobilize the injury to ensure the joint heals properly. Reticular bruises tend to heal the fastest. Smokers, beware: lighting up can make your bruise linger for even longer, so experiencing this type of injury can and should be your inspiration to finally quit! 1996 Jan;25(1):49-54. doi: 10.1007/s002560050031. Given this risk and the patients presentation, surgical intervention was performed. ankle sprain series: ankle: ankle sprain intro: Ankle Anatomy: ankle injury: geoff jenkins ankle injury: alabama ankle injury: sprained ankle: Katy Perry kissing in teenage dreams; Katy Perry; Katy Perry Hot; Katy Perry without makeup; freida Pinto hot; freida Pinto cool pics; freida Pinto on maxim; GET THE RIGHT SIZE FOR THE BEST FIT - Refer to our size chart to get the best fit. Please enable it to take advantage of the complete set of features! During his workup, an MRI shows a 1x1 cm lateral talar osteochondral defect (OCD). Little Women (2019) Jo March reflects back and forth on her life, telling the beloved story of the March sisters - four young women, each determined to live life on her own terms. Symptoms: The main symptoms is pain and swelling of the knee joint which due to the injury of the ligaments and muscles. Acta Orthop Scand, Staals EL, Bacchini P, Mercuri M, Bertoni F. Dedifferentiated chondrosarcomas arising in preexisting osteochondromas. She was released to full weight-bearing and regular shoe wear three months from her date of surgery. The objective of this study was to determine the presence and location of subchondral bone contusions, fractures, and "kissing" lesions of the talotibial joint after a sprain of the ankle shown on MR imaging. (c)Rest of the affected joint or leg is very essential to prevent further damage. This was demonstrated in our patient who had subtalar arthrosis adjacent to peri-articular talar and calcaneal osteochondroma. The results will vary depending on the type of the MRI. A midline incision was used , splitting the Achilles tendon centrally in a longitudinal fashion. Muscle ruptures are usually straightforward; sudden intense pain . Stress fractures as a result of repeated trauma, Inflammation of the bone or joint (reactive arthritis, bacterial arthritis or osteomyelitis), Osteopenia that is weak bones in malnourished individuals, Haematoma within the bone in people with bleeding disorders.