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
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Info

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

This study is a stack
Sagittal
T1
This study is a stack
Sagittal
T2 fat sat
This study is a stack
Coronal
PD
This study is a stack
Coronal PD
fat sat
This study is a stack
Axial
PD
This study is a stack
Axial T2
fat sat
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Info

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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