Pathologies and Postoperative Features of Posterior Tibial Tendon Dysfunction: A Pictorial Essay

[1] In posterior tibial tendinosis, the tendon appears thickened with normal or increased signal intensity on both T1- and proton density[-]weighted images (Figure 3); these intrasubstance signals represent severe degeneration or intrasubstance tears not reaching the tendon surface, thus there is a...

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Bibliographic Details
Published in:Hong Kong journal of radiology : HKJR = Xianggang fang she ke yi xue za zhi 2024-03, Vol.27 (1), p.e51
Main Authors: Mak, RYS, Cheng, JHM, Chin, KH, Chu, CY
Format: Article
Language:English
Subjects:
Ankle
Calcification
Foot diseases
Ligaments
Magnetic resonance imaging
Pain
Rheumatoid arthritis
Tendons
Trauma
Ultrasonic imaging
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Summary:[1] In posterior tibial tendinosis, the tendon appears thickened with normal or increased signal intensity on both T1- and proton density[-]weighted images (Figure 3); these intrasubstance signals represent severe degeneration or intrasubstance tears not reaching the tendon surface, thus there is a certain degree of overlap of the appearance of tendinosis and partial tear. Magnetic resonance imaging of his right ankle issuggestive of posterior tibial tendon dysfunction. (a-d) Axial fat-saturated (FS) proton density (PD)[-]weighted magnetic resonance imaging(MRI) of the posterior tibial tendon from proximal to distal show increased signal and abnormal thickening of the tendon at the level of distaltibia and talus (blue arrowheads in [a] and [d]), suggestive of tendinosis. Magnetic resonanceimaging (MRI) of the left ankle revealed a split tear of the posterior tibial tendon (PTT). (a-c) Axial fat-saturated (FS) proton density (PD)[-]weighted MRI from proximal to distal reveal a grossly thickened PTT with a full thickness split tear, leading to the four-tendon sign (arrows).(d, e) A type II os naviculare with slight increase in marrow fluid signal (arrowhead in [d]) on the FS PD-weighted sequence could representos naviculare syndrome. (f) Coronal FS PD-weighted MRI showing thinning of the superomedial calcaneonavicular ligament (curved arrow),a component of the spring ligament complex, suggestive of partial tear. Magneticresonance imaging (MRI) of her right ankle was performed. (a, b) Axial fat-saturated (FS) proton density (PD)[-]weighted MRI of the right anklefrom proximal to distal show absence of the right posterior tibial tendon, suggestive of complete tear. (c, d) Increased signal in the deltoidligament in the FS PD-weighted sequence
ISSN:2223-6619
2307-4620
DOI:10.12809/hkjr2217677