Ankle – Posterior tibial tendon tear

CASE HISTORY

Posterior tibial tendon dysfunction evaluate for rupture. Medial ankle pain and sensation of instability.

TECHNICAL FACTORS

Long- and short-axis fat- and water-weighted images were performed.  

KEY IMAGES

This case has no key images.

CASE FINDINGS

• Tendons:  
  • Large high-grade supramalleolar retromalleolar and inframalleolar tear with cystic degeneration and marked hypertrophy of the tendon with a length of greater than 5-6cm.  
• Lateral group normal.  
• Anterior group normal.  
• Posterior group normal.  
• Skeleton:  
  • Hypertrophic bifid posterior tibial tendon groove behind the tibia likely contributing to giant cystic tear of the posterior tibial tendon.    
• Inflamed intraosseous ganglion of the inferior talus.  
• Soft Tissues:  
  • Subtalar space bursal swelling.  
• Articular:  
  • First tarsometatarsal joint class 4 chondromalacia.    
• 1+ effusion.  
• Plantar Fascia:  
  • Normal.  
• Neurovascular Bundle:  
  • Normal.  
• Soft Tissue Masses:  
  • None other than pseudomass of posterior tibial tendon.  
• Haglund Deformity:  
  • Small posterosuperomedial present.    
• Collaterals:  
  • Intact.  
• Soft Tissues:  
  • Swollen medially and along the anterolateral soft tissue region.

CASE CONCLUSION

Larger giant hypertrophic cystic tear of the supra- juxta- and inframalleolar posterior tibial tendon with stretched laciniate ligament or medial retinaculum and developmental variation of bifid posterior tibial tendon bony groove.