Presentation
Left ankle pain, posterior to the medial malleolus. History of flat foot.
Patient Data
Age: 40 years
Gender: Female
From the case:
Tibialis posterior interstitial tear
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The tibialis posterior tendon is markedly thickened (compare it to the adjacent flexor digitorum tendon), showing intratendinous partial interstitial tear, its tendon sheath is distended by fluid signal (tenosynovitis).
Case Discussion
Chronic posterior tibial tendon rupture is associated with flat foot deformity.
The tear is commonly noted behind the medial malleolus (the significant site of friction).
Chronic posterior tibial rupture is divided into 3 types:
type I: incomplete/partial tear with diffuse tendon enlargement showing intrasubstance degeneration/longitudinal splits.
type II: partial tear with diffusely thinned tendon.
type III: complete tear.
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