The patient is generally healthy and takes no prescription medicines or supplements. He has no allergies to medicines. He gives no history of previous surgery or illnesses. The rest of the review of systems is negative in detail. There is no significant family history. Examination of the foot shows there is a soft, slightly mobile, soft tissue mass in the anteromedial portion of the right ankle that measures approximately five by 3 cm and appears to be about 1 cm thick. It is nontender. There is synovitis and swelling in the ankle generally. There is pain and tenderness along the course of the posterior tendon behind the medial malleolus. The range of motion of the ankle is slightly reduced. The overall alignment and arch of the foot is preserved. The neurovascular status is normal. There is no skin lesion and no cafe au lait spots are seen. No popliteal or inguinal lymphadenopathy is palpated.