Sports induced medial ankle pain in an adolescent

A previously healthy 11-year-old male adolescent, presented with right ankle pain of the last 2 months. Pain was typically exacerbated after football and volleyball activities. No history of trauma was reported. The patient was not on medication and had an otherwise unremarkable medical history. Clinical examination revealed an oedematous and painful at palpation medial malleolus at the malleolar insertion of the deltoid ligament. The foot was painful upon pronation and to a lesser degree upon supination. Dorsiflexion and plantar flexion were normal. An anteroposterior radiograph of both ankle joints ( Fig. 1 ) and coronal T1-w (b) and fat suppressed T2-w ( Fig. 3 ) MR images, are shown.