Differential Diagnosis for Right Ankle MRI Findings
- Single most likely diagnosis
- Salter-Harris 1 fracture of the distal fibular physis: This diagnosis is most likely because the MRI findings of bone marrow edema of the distal fibula and a linear region of low signal extending from the physis distally are consistent with a fracture. The plain radiographs also suggested this diagnosis.
- Other Likely diagnoses
- Ligamentous injury: The patient's tenderness over the lateral malleolus and the query of ligamentous injury in the history suggest that a ligamentous injury could be present, possibly in conjunction with the fracture.
- Distal fibular stress fracture: The bone marrow edema and linear region of low signal could also be consistent with a stress fracture, although the history and plain radiographs suggest a more acute injury.
- Do Not Miss diagnoses
- Osteomyelitis: Although less likely, osteomyelitis could present with bone marrow edema and should be considered, especially if the patient has symptoms such as fever or increased white blood cell count.
- Septic arthritis: Similarly, septic arthritis could present with joint effusion and bone marrow edema, and is a potentially serious condition that should not be missed.
- Rare diagnoses
- Osteonecrosis: The bone marrow edema could potentially be consistent with osteonecrosis, although this would be an unusual diagnosis in this context.
- Bone tumor: A bone tumor could also present with bone marrow edema, although the acute presentation and plain radiograph findings make this less likely.