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Imaging Quiz Question

Posterior Ankle Pain in a Recreational Athlete

Carlos E. Jiménez, MD; Ernesto Torres, MD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 26 - NO. 12 - DECEMBER 2021


A 21-year-old male recreational soccer player presented with right posterolateral ankle pain of 4 weeks' duration that was provoked by prolonged weight-bearing and significant plantar flexion. Running, jumping, and kicking the ball exacerbated the pain. On physical examination, tenderness was noted anterolateral to the Achilles tendon and posterior to the talus. Resisted plantar flexion accentuated the pain. Anteroposterior, lateral, and mortise view radiographs revealed no bony lesions. A technetium 99m methylene diphosphonate bone scan (figure 1) was then obtained.

What is your diagnosis, and what treatment would you recommend?

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the US Dept of the Army or the Dept of Defense.

Dr Jiménez is a staff physician in the nuclear medicine service in the department of radiology and Dr Torres is a radiology resident, both at Walter Reed Army Medical Center in Washington, DC. Dr Jiménez is also an assistant professor of radiology/nuclear medicine at the Uniformed Services University of Health Sciences in Bethesda, Maryland, and a member of the Society of Nuclear Medicine and the American College of Physicians. Dr Torres is a member of the American College of Radiology and the American Roentgen Ray society. Address correspondence to Carlos E. Jiménez, MD, 12021 Bernard Dr, Silver Spring, MD 20902.


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