Tibialis posterior tenosynovitis

Case contributed by Dr Bahman Rasuli

Presentation

Right ankle pain, posterior to the medial malleolus.

Patient Data

Age: 45 years
Gender: Female

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.

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