Tibialis anterior tendon rupture - atraumatic

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Anterior foot pain, difficulty walking. No trauma.

Patient Data

Age: 65 years
Gender: Female

Full-thickness rupture of tibialis anterior at the level of the ankle joint. Tibialis posterior is intact. 

MRI confirms a full-thickness tibialis anterior rupture at the level of the ankle joint with a significant gap and tendon retraction. The intact proximal tibialis anterior tendon appears tendinopathic being markedly thicker than the other extensor tendons with heterogeneous high signal. 

Case Discussion

The patient proceeded to operative fixation of the tibialis anterior tendon. Tibialis anterior tendon ruptures are uncommon and atraumatic ruptures occur in tendinopathic tendons in patients >45 years with risk factors including inflammatory arthropathy, gout, diabetes mellitus or corticosteroid treatment. 

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