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RIGHT FOOT:   Weight-bearing views of the right foot show marked sclerosis, periarticular osteophytosis and joint space loss at the tibiotalar joint with what appears to be partial collapse of the talus. A large amount of soft tissue swelling is evident at the ankle and diffuse osteopenia is seen. There is buckling of the trabecular framework in the region of the calcaneai neck, suggesting fracture. A bony fragment measuring approximately 15 mm is seen at the posterosuperior aspect of the calcaneus. No old films are available for comparison.

IMPRESSION:   Possible fracture. LEFT SHOULDER:  Multiple views of the left shoulder show inferiorly sloping acromion process. The acromiohumeral space measures 8 mm in neutral position and 3 mm in internal rotation. The articular surfaces at the glenohumeral joint space are normal.

IMPRESSION:  Findings suggestive of impingement. RIGHT THUMB:  AP and lateral views of the right thumb show a small bony fragment seen dorsally at the first DIP joint overlying the proximal phalangeal head. A small amount of soft tissue swelling is seen here.

IMPRESSION:  As above/fracture?
C-SPINE:   Multiple views of the cervical spine show poor visualization of C7 on the if flexion and extension views, and the neutral view of the lateral cervical spine was not obtained. No evidence of spondylolisthesis or instability is evident on flexion or extension. Narrowing of the (23-4 foramen on the right secondary to facet and vertebral joint hypertrophy. Otherwise, the C–spine is normal in appearance.

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