55-year-old female with posterior tibial tendon dysfunction and sensation of instability
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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.
- 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.
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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