The patient is here today because of pain in the ankles. She has pain with activity. She has swelling with activity. There is good range of motion of both ankles, normal alignment, good circulation, normal neurovascular status, subtalar joint motion is intact. Palpation elicits pain mostly over the distal tibia on both sides and over the anterior neck of the talus bone on both sides. X-rays of the ankles are made today on both sides, and AP and lateral view. There is normal smooth joint space, normal subchondral density without apparent collapse, no subchondral sclerosis, and no subchondral lucency. The MRIs tell a very different story. There is extensive bilateral multifocal lesions in the talus bone, calcaneus, navicular, and this pattern of other areas of the foot bilaterally. The distal tibia and distal femur also have large areas of abnormal appearance.