Chronic tenosynovitis of the posterior tibial tendon with new bone formation

Abstract

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.

Subtendinous Bone Marrow Edema Patterns on MR Images of the Ankle

“…Dysfunction of the tendons can lead to altered stress placed on the underlying cortical bone, which may undergo a hyperemic or proliferative response. This effect has been suggested by prior studies in which bone proliferation at a nonarticular portion of the medial malleolus and calcaneus was found to be associated with chronic posterior tibial and peroneal tenosynovitis, respectively [21][22][23]. We hypothesized that, on MR images, an earlier stage of this response could present as marrow edema under sites of friction or next to hyperemic tendon sheaths.…”

A case of valgus ankle in an early Pleistocene hominin

“…As the disorder proceeds the deltoid ligament weakens, resulting in a valgus tilt of the tibiotalar joint (Myerson, 1996; Gibson & Prieskorn, 2007; Bluman & Chiodo, 2008). Possible consequences of PTTD include degeneration of the lateral tibial plafond and stress fractures of the fibula (Norris & Mankin, 1978; Myerson, 1996; Bluman & Chiodo, 2008).…”

Does Radial Styloid Abnormality in de Quervain's Disease Affect the Outcome of Management?

“…X-rays may show skeletal changes in the radial styloid which could irritate the tendons [4]. Reactive periostitis from the inflammation of the tendon sheath has been proposed as the etiological factor for skeletal changes [1, 6]. Poulsen, in 1911, attributed the condition to chronic irritation in the periosteum due to straining through the tendovaginal compartment, and he named it traction periostitis similar to periostitis in the tibia [2].…”

“…Poulsen, in 1911, attributed the condition to chronic irritation in the periosteum due to straining through the tendovaginal compartment, and he named it traction periostitis similar to periostitis in the tibia [2]. Periosteal new bone formation around the posterior aspect of the medial malleolus has been reported in tenosynovitis of the posterior tibial tendons [6]. There could be inflammation of the peritendinous structures [3].…”