The predictive role of the posterior tibial tendon cross-sectional area in early diagnosing posterior tibial tendon dysfunction

Abstract

A hypertrophied posterior tibial tendon (PTT) has been considered to be an important morphologic parameter of PTT dysfunction (PTTD). Previous research has demonstrated that the PTT thickness (PTTT) is correlated with early signs of PTTD. However, the thickness is different from hypertrophy. Thus, we devised the PTT cross-sectional area (PTTCSA) as a new predictive parameter for diagnosing the PTTD. The PTT data were acquired from 14 patients with PTTD and from 20 normal individuals who underwent ankle magnetic resonance imaging. We measured the PTTT and PTTCSA at the PTT on the ankle magnetic resonance imaging. The mean PTTT was 2.43 ± 0.39 mm in the normal group and 3.40 ± 0.42 mm in the PTTD group. The average PTTCSA was 16.10 ± 4.27 mm 2 in the normal group and 26.93 ± 4.38 mm 2 in the PTTD group. The receiver operator characteristic analysis curve demonstrated that the highest predictive value of the PTTT was 3.07 mm, with 85.7% sensitivity, 85.0% specificity. The highest predictive value of the PTTCSA was 22.54 mm 2 , with 92.9% sensitivity, 90.0% specificity. Our findings suggest that the PTTCSA was a more valid predictor of PTTD, even though the PTTT and PTTCSA were both significantly associated with PTTD.

Assessments Associated with the Diagnostics and Non-Surgical Treatment of Posterior Tibialis Tendon Dysfunction: A Systematic Review

“…The inclusion criteria varied among the studies, with some studies having strict criteria and others being more generalized. Some participants with a previous PTTD diagnosis or medical history indicating PTTD were included; however, no further examination was undertaken to confirm this [18,19,31]. Other participants were included based on signs and symptoms, such as localized oedema, asymmetric acquired flatfoot deformity, and pain [23].…”

“…Certain parameters using MRI are used to provide a positive diagnosis. One paper compared the cross-sectional area and the TP thickness, finding that TP cross-sectional area is the more sensitive measurement [19]. Another paper highlights that finding the pathology requires looking specifically at tenosynovial fluid rather than just intrasubstance TP pathology.…”

How Common is Subsequent Posterior Tibial Tendon Dysfunction or Tarsal Tunnel Syndrome After Ankle Sprain Injury?

“…In the first block, age, female sex, and cardiometabolic conditions were included based on relationships reported previously in the literature. [26][27][28][29][30][31] Block 2 included ankle sprain type and military sponsor's demographics, as additional variables of clinical relevance that were unique to our sample. This model was chosen because it allows for the management of a large number of predictor variables and can help determine how much a dependent variable can be explained beyond variance already explained by other variables.…”