@María Pilar Diezhandino Gallo-Ruiz Sad case for the patient indeed. Multiple pre-operative radiographs and MRIs were all reported with no mention of a calcaneonavicular coalition. However, the pediatric orthopedic surgery team thought that they saw one per their own read. In their operative note, they doubled down and said that they found one and resected it Now that the patient carries this diagnosis in medical record, there is concern that the patient has recurrence of this phantom coalition as a cause for his worsening symptoms. I hope he is not taken back to the OR Many lessons to be learned. Radiologists should not always blindly trust operative reports (and pathology reports for that matter) if things are discordant with imaging findings. The gold standard isn't correct 100% of the time. This case also serves as motivation for us all to improve our interpretation skills so that surgeons don't ignore our reads, thinking that they can do better

@Marlena Jbara Love the insight re: repairing plantar plate tears without addressing the cause

I concur Disclaimer: Only looked at the stills

Based on the still images and clinical history, agree with traction periostitis from tibialis anterior This RadSource article has a nice discussion of differential. They talk about how differentials, including chronic exertional compartment syndrome (CECS) and bony stress injuries, can all coexist. One technique they describe for CECS is to perform imaging before and after exercise and to look for increased muscle size and edema after exercise As for other etiologies, the author adds muscle strain, DVT, muscle hernia, etc. DVT is an interesting consideration given the ancillary findings in your case: "However, unlike compartment syndrome, deep venous thrombosis causes venous occlusion and commonly results in subcutaneous edema and skin thickening, which are all findings that can be displayed with MR imaging" https://radsource.us/compartment_syndrome_leg/

Very difficult case, looking forward to the follow-up MRI. Thanks Professor Hermann for the explanation