Thank you everyone for your responses.
I remember seeing a case like this posted a long time ago on OCAD but could
not find it, so thank you for your patience.
Most responders agree that the lesion is a post traumatic fibrous
band/synechia/blood clot. I have seen this before but never quite as large
as this one.
Dr Bill Breidahl kindly shared an article on this.
in <pubmed.ncbi.nlm.nih.gov/17107532/> ntra-articular fibrous band
of the ankle: an uncommon cause of post-traumatic ankle pain.
Slavotinek JP, Zadow S, Martin DK.Australas Radiol. 2006 Dec;50(6):591-3.
doi: 10.1111/j.1440-1673.2006.01639.x.
Have a great day
Kind regards
Colin