55-year-old female with posterior tibial tendon dysfunction and sensation of instability
Posterior tibial tendon dysfunction evaluate for rupture. Medial ankle pain and sensation of instability.
Long- and short-axis fat- and water-weighted images were performed. Â
- Tendons: Â
- 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. Â
- Lateral group normal. Â
- Anterior group normal. Â
- Posterior group normal. Â
- Skeleton: Â
- Hypertrophic bifid posterior tibial tendon groove behind the tibia likely contributing to giant cystic tear of the posterior tibial tendon. Â Â
- Inflamed intraosseous ganglion of the inferior talus. Â
- Soft Tissues: Â
- Subtalar space bursal swelling. Â
- Articular: Â
- First tarsometatarsal joint class 4 chondromalacia. Â Â
- 1+ effusion. Â
- Plantar Fascia: Â
- Normal. Â
- Neurovascular Bundle: Â
- Normal. Â
- Soft Tissue Masses: Â
- None other than pseudomass of posterior tibial tendon. Â
- Haglund Deformity: Â
- Small posterosuperomedial present. Â Â
- Collaterals: Â
- Intact. Â
- Soft Tissues: Â
- Swollen medially and along the anterolateral soft tissue region.
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.
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