חבלה בכף רגל. MRIמצורף. מבקש חוות דעת והמלצה על טיפול

FINDINGS: THE PATIENT HAS MODERATE TO SEVERE DEGENERATIVE (OSTEOARTHRITIC) CHANGES AT MULTIPLE ARTICULATIONS IN THE ANKLE. THIS IS PARTICULARLY EVIDENT IN THE TALOTIBIAL JOINT AND THE ARTICULATION OF THE MEDIAL CONIFORM WITH THE BASE OF THE FIRST METATARSAL. THERE IS IRREGULAR THINNING AND EROSION OF THE ARTICULAR CARTILAGE. THERE IS ASSOCIATED DEVELOPMENT OF SMALL DEGENERATIVE TYPE SUBCHONDRAL CYSTS AS WELL AS REACTIVE FIBROVASCULAR MARROW CHANGES. THERE IS A SMALL DEGENERATIVE TYPE CYST IN THE MEDIAL TALAR DOME WITH SURROUNDING MILD OSTEOSCLEROSIS AND MILD MARROW EDEMA. THIS ALSO APPEARS TO BE DEGENERATIVE IN NATURE. OSTEOCHONDRITIS DISSECANS IN THIS REGION IS HIGHLY UNLIKELY BUT CANNOT BE COMPLETELY EXCLUDED. THERE IS A SMALL TALOTIBIAL JOINT EFFUSION WITHOUT EVIDENCE OF ANY FREE LOOSE BODIES. THERE IS A SMALL SYNOVIAL CYST EXTENDING POSTERIOR TO THE TALUS MEASURING UP TO 1.8 CM IN DIAMETER. THE TENDONS APPEAR GROSSLY INTACT. IN PARTICULAR, THE POSTERIOR TIBIALIS TENDON APPEARS GROSSLY INTACT. THERE IS MODERATE THICKENING AND HYPERINTENSITY AT THE DELTOID LIGAMENT, SUGGESTIVE OF A PARTIAL TEAR OR A MODERATE TO SEVERE SPRAIN. HOWEVER, THERE IS NO EVIDENCE OF COMPLETE TEAR OR DETACHMENT OF THE LIGAMENT. THE REMAINDER OF THE LIGAMENTS, INCLUDING THE ATFL APPEAR INTACT