hi tony,

I am not very happy with the first sentence, outlined under findings;
metallic artefact is noted associated with the medial malleolus as well as the lateral malleolus.

although artefacts cannot be considered as a biological effect of the MR process, I should admit misinterpretation can yield devastating consequences. a metallic artifact can show up depending upon the size of the metallic implant, type of metal, the pulse sequence and the imaging parameters used.

in some cases even though there is no metal within the patient it can show up, this could indicate the presence of blood products most commonly a hemorrhagic lesion. The ferromagnetic properties of iron in the blood may create fluctuations in local magnetic field.

well, I am concerned as your pain presentation is "inappropriate", sorry to say so. for a person with otherwise normal post-surgical ankle the pain presentation is not as bad as yours (as per your post). so kindly get a specialist second opinion to rule out - presence of any metallic fragments in situ (? sequlae of surgical procedure) and or whether the separate bony fragment (outlined further down - report) is interfering while weight bearing etc.....

all the best and keep us (physio forum) posted.

cheers,

thomas