Right ankle pain

A 38-year-old female complained of right ankle pain that started last year. The patient disputes that any known injury or aggravating circumstance led to discomfort. Physical examination reveals no anomalies in the ankle; however, range of motion tests show mild generalized pain in the talus. An ankle radiograph is done (Figure 1), which was found to be normal. Oedema in the talus is visible on sagittal magnetic resonance imaging (MRI, Figure 2), which is consistent with avascular necrosis. The ankle joint does not show any symptoms of collapsing, and the avascular alterations seem to be more pronounced in the head of the talus.