Presentation
Right ankle pain, posterior to the medial malleolus.
Patient Data
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Mortise joint effusion
The posterior tibialis tendon (PTT) demonstrates marked swelling and intrasubstance high signal intensity changes just below the medial malleolus level and a fluid signal around it. Adjacent surrounding soft-tissue and subcutaneous edematous changes noted.
A calcaneal spur is also noted.
Case Discussion
Tibialis posterior dysfunction is common, mostly affecting middle-aged and elderly females, and can progress to adult acquired flat foot disease. MRI is useful in the assessment of the tibialis posterior tendon and its dysfunction such as tenosynovitis, tearing, and pes palnus deformity.