Chronic non-specific tenosynovitis of the posterior tibial tendon is a well-known clinical entity, characterised by pain, swelling and tenderness behind the medial malleolus. There are no reports in the literature of any case associated with any radiological abnormality. Three such cases are discussed, each presenting with the clinical findings typical of the syndrome but with associated radiological changes. These changes may pose diagnostic problems and several primary conditions need to be excluded. Surgical decompression of the tendon may be necessary to relieve symptoms, to prevent erosion and rupture of the tendon, and to establish the diagnosis.
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