Tenosynovial fluid as an indication of early posterior tibial tendon dysfunction in patients with normal tendon appearance

Gonzalez, Felix M.; Harmouche, Elie; Robertson, Douglas D.; Umpierrez, Monica; Singer, Adam D.; Younan, Yara; Bariteau, Jason T.

doi:10.1007/s00256-018-3142-y

Cited by 16 publications

(9 citation statements)

References 20 publications

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“…Indications for tendoscopy of the PTT include tenosynovitis, tendinosis, degenerative tears, tendon adhesion, and dislocation. 14-17 In these patients, hydrocele of the PTT sheath was seen on MRI and tenosynovitis was suspected 18 , although tenosynovitis was not particular, and rupture of the cartilaginous bed was detected. Leakage of joint fluid into the tendon sheath after injury to the joint capsule or ligament can be confirmed by arthrography.…”

Section: Discussionmentioning

confidence: 89%

Fibrocartilaginous Bed Injury of the Posterior Tibial Tendon Sheath

Shoji

Sugimoto

Isomoto

et al. 2022

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Cases:Three athletes (2 female gymnasts and 1 male rugby player) complained of persistent posteromedial ankle pain after an ankle injury. Arthroscopy of the ankle and tendoscopy of the posterior tibial tendon (PTT) were performed in 2 patients with prolonged symptoms and in 1 patient with acute severe pain. A small rupture at the fibrocartilaginous bed of the PTT with pinhole communication between the PTT sheath and the ankle joint cavity was detected, and open repair of the fibrocartilaginous bed was performed.Conclusion:All patients returned to their respective sports without any residual symptoms after open repair of the fibrocartilaginous bed.

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Section: Discussionmentioning

confidence: 89%

Fibrocartilaginous Bed Injury of the Posterior Tibial Tendon Sheath

Shoji

Sugimoto

Isomoto

et al. 2022

JBJS Case Connector

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“…The posterior tibial tendon has a similar structure surrounded by a synovial sheath that demonstrates this protective pattern. In late stages of tendinopathy, lower PSFR values have been reported in non-dancer populations clinically diagnosed with posterior tibial tendinopathy only when the synovial sheath was found to be disrupted [ 13 , 26 , 28 ]. This supports the idea that the sheath is protective against pathologic changes in tissue organization.…”

Section: Discussionmentioning

confidence: 99%

“…Altered mechanical function also occurs due to the development of nodules and alterations to the tendon proper and, clinically, this can present as trigger toe in advanced disease process [ 12 ]. The presentation of FHL tendinopathy may differ from more extensively studied tendinopathies like Achilles or patellar due to the presence of this sheath, making it structurally more similar to the posterior tibial tendon [ 13 ]. The differences in how tendon pathology develops in a tendon covered in paratenon like a patellar tendon compared to a sheathed tendon like posterior tibial tendons limit direct comparisons to commonly studied tendons when investigating tendinopathy of these sheathed tendons.…”

Section: Introductionmentioning

confidence: 99%

“…Tendons demonstrate thickening as a normal adaptive mechanism with increased use, but with unhealthy loads, there can be maladaptation. This can be seen as pathologic thickening of the tendon itself or swelling of the structures surrounding the tendon [ 13 ]. In the presence of tendinopathy, there are micromorphological changes seen in the tissue from a dysfunctional healing response, and the tendon presents with disrupted or thinner collagen bundles, hypercellularity, an increase in proteoglycans, and often neovascularization [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Flexor hallucis longus tendon morphology in dancers clinically diagnosed with tendinopathy

et al. 2023

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Purpose The unique demands of dance technique make dancers more prone to certain pathologies especially of the foot and ankle. Flexor hallucis longus (FHL) tendinopathy, colloquially known as “dancer’s tendinopathy,” is common in dancers and not well studied. The purpose of this study was to assess if morphological alterations in tendon structure occur as an adaptive response to dance activity by comparing the FHL tendon in dancers to non-dancers, and if pathology further alters tendon morphology in dancers clinically diagnosed with tendinopathy. Methods Three groups of ten participants were recruited (healthy non-dancers, healthy dancers, and dancers with FHL tendinopathy). Ultrasound images of the FHL tendons were analyzed for macromorphology by measuring the tendon thickness. The micromorphology was analyzed by determining the peak spatial frequency radius of the tendon. Our study did find increased tendon proper and composite tendon thickness in dancers with tendinopathy but no difference between asymptomatic dancers and non-dancers. Results There was no significant difference in micromorphology found between any of the groups. As expected, dancers with tendinopathy demonstrated increased composite tendon and tendon proper thickness however, there was no evidence of adaptive thickening of the FHL tendon as might be expected for the dance population. There was also no evidence of micromorphological changes in the presence of clinically diagnosed FHL tendinopathy. Conclusion Because of the limited normative data for this pathology, these results can help improve diagnosis and therefore treatment for dancers to decrease the impact of this injury on their careers.

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“…Die Begutachtung der PTT ist in der klinischen Untersuchung essenziell. Schmerzen und Schwellung über dem Sehnenverlauf können auf das Vorliegen einer Tendinitis oder Tendosynovitis hinweisen 13 , 14 . Das Vorliegen einer Schwäche der PTT soll seitenvergleichend gegen aktiven Widerstand getestet werden.…”

Section: Diagnostikunclassified

Erworbener Plattfuß: Diagnose und chirurgische Behandlung

Döring¹,

Vertesich²,

Puchner³

2021

Z Orthop Unfall

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ZusammenfassungDer erworbene Plattfuß des Erwachsenen präsentiert sich als langsam progrediente Deformität, die unbehandelt zu quälenden Schmerzen und Einschränkungen der Aktivitäten des täglichen Lebens führen kann. Die Therapiemaßnahmen sind vielfältig und abhängig von klinischer und radiologischer Präsentation, sodass für jeden Patienten eine individuelle Versorgung geplant werden muss. Dieser Beitrag spannt einen Bogen von der Ätiopathogenese über die chirurgische Therapie bis hin zur postoperativen Mobilisierung und Rehabilitation.

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Tenosynovial fluid as an indication of early posterior tibial tendon dysfunction in patients with normal tendon appearance

Cited by 16 publications

References 20 publications

Fibrocartilaginous Bed Injury of the Posterior Tibial Tendon Sheath

Fibrocartilaginous Bed Injury of the Posterior Tibial Tendon Sheath

Flexor hallucis longus tendon morphology in dancers clinically diagnosed with tendinopathy

Erworbener Plattfuß: Diagnose und chirurgische Behandlung

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