Tenosynovitis - tibialis anterior

Case contributed by Maulik S Patel


Focal swelling in mid foot - dorsum - Few days.. C/o pain. No obvious trauma.

Patient Data

Age: 30 yrs
Gender: Male

At site of swelling pointed by patient, there is Focal area of synovial sheath thickening involving tibialis anterior tendon. Minimal fluid was noted in adjacent sheath. Local hypervascularity is seen in thickened sheath. Tendon echopattern is normal - fibrillar type without any hypoechoic areas.

No tendon tear is noted.

Last image shows side by side comparision of symptomatic and asymptomatic tendons in short axis.  

Symptomatic side shows hypoechoic thickened sheath around tendon which is absent around asymptomatic tendon.

Asymptomatic tendon appears tobe hypoechoic than symptomatic one , due to anisotropy artifact.


Case Discussion

Findings favor tenosynovitis of tibialis anterior tendon.

There was no direct injury to anterior ankle. However, patient had developed achilles tendinosis of contralateral foot 1 mth back. He was asked by orthopedic surgey to wear sports shoe. He began wearing shoe for the first time at the age of thirty yrs. He drives a four wheeler all the day. Tight shoe lace is possibility the case of tenosynovitis of tibialis anterior tendon.


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