Tibialis posterior dysfunction

Last revised by Doaa Faris Jabaz on 19 Oct 2023

Citation, DOI, disclosures and article data

Citation:

Knipe H, Jabaz D, Yap J, et al. Tibialis posterior dysfunction. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-71587

DOI:

https://doi.org/10.53347/rID-71587

Permalink:

https://radiopaedia.org/articles/71587

rID:

71587

Article created:

13 Oct 2019, Henry Knipe ◉ ◈

Disclosures:

At the time the article was created Henry Knipe had no recorded disclosures.

View Henry Knipe's current disclosures

Last revised:

19 Oct 2023, Doaa Faris Jabaz

Disclosures:

At the time the article was last revised Doaa Faris Jabaz had no financial relationships to ineligible companies to disclose.

View Doaa Faris Jabaz's current disclosures

Revisions:

11 times, by 7 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Tags:

Synonyms:

Posterior tibialis dysfunction
Posterior tibialis degeneration
Posterior tibial dysfunction
Tibialis posterior degeneration
TP tendon dysfunction
Dysfunction of tibialis posterior
Tibialis posterior tendon dysfunction

Tibialis posterior dysfunction is common, mostly affecting middle-aged and elderly females, and can progress to adult-acquired flatfoot disease.

Dysfunction occurs secondary from repetitive overloading resulting in degeneration, which occurs in the typical continuum of tenosynovitis and tendinosis progressing to partial and full-thickness tendon tears. Elongation can also occur without tearing, with as little as 1 cm of elongation resulting in dysfunction ¹.

Tibialis posterior can tear in its ¹:

supramalleolar part (uncommon)
retromalleolar part
inframalleolar part (most common)

Etiology

Tibialis posterior dysfunction can be secondary to ³:

trauma
underlying disease, e.g. inflammatory arthropathy
idiopathic
functional, e.g. tarsal coalition

Risk factors

congenital pes planus
accessory navicular or cornuate navicular
obesity
diabetes
gout
inflammatory arthropathy
hypertension
corticosteroid use

Radiographic features

Plain radiograph

Secondary features of tibialis posterior dysfunction include ¹:

soft tissue swelling
navicular tuberosity enthesopathy
retromalleolar groove bone hypertrophy
in some cases, there may be subtalar arthritis

Ultrasound

tendon sheath effusion and diameter >7 mm reflects tenosynovitis ¹

Associations

In advanced posterior tibial tendon injury, increased force is transmitted to other stabilizers of the medial longitudinal arch of the foot. Associations include: