Tibialis posterior tear

Case contributed by Dalia Ibrahim
Diagnosis certain

Presentation

Pain and swelling along the medial aspect of the ankle. Marker was applied to the patient's complaint.

Patient Data

Age: 50-year-old
Gender: Female
mri

The tibialis posterior tendon (behind the medial malleolus) is markedly thickened (compare it to the adjacent flexor digitorum tendon), showing intrasubstance degenerative signal and partial tear (evident along its anterior fibers), its tendon sheath is distended by fluid signal (tenosynovitis).

Adjacent bone marrow edema of the medial malleolus is noted and extensive subcutaneous soft tissue edema signal.

Case Discussion

Type I tibialis posterior tendon tear.

Chronic posterior tibial rupture is divided into 3 types:

  • type I: incomplete/partial tear with diffuse tendon enlargement showing intrasubstance degeneration/longitudinal splits.
  • type II: partial tear with diffusely thinned tendon.
  • type III: complete tear.

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