Journal of Ultrasound in Medicine, Vol 16, Issue 6 417-423, Copyright © 1997 by American Institute of Ultrasound in Medicine
Diagnostic efficacy of ultrasonography in stage I posterior tibial tendon dysfunction: sonographic-surgical correlation
Y. J. Chen and S. C. Liang
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
The purpose of this study is to evaluate the diagnostic efficacy of
ultrasonography in stage I posterior tibial tendon dysfunction. Fourteen of
the 17 consecutive patients who underwent tenosynovectomy for stage I
posterior tibial tendon dysfunction were included in this study. The
preoperative diagnosis was based primarily on the clinical suspicion of
dysfunction, which was confirmed by ultrasonography. Two measurements were
obtained at the midpoint between the insertion site and the medial
malleolus in both feet of the 14 patients: the diameter of the posterior
tibial tendon and the diameter of the tendon sheath measured from its inner
walls. The mean diameter of the tendon was 4.61 +/- 0.50 mm and that of the
tendon sheath in the symptomatic foot was 7.24 +/- 0.75. In the unaffected
foot, the mean diameter of the tendon was 3.30 +/- 0.34 mm and that of the
tendon sheath was 3.64 +/- 0.35 mm, respectively. In the symptomatic
tendon, the increase of peritendinous space was significantly higher than
the increase in the tendinous portion (P < 0.0001). Surgical findings
proved the accuracy of diagnosis in all patients. Although many cases of
stage I posterior tibial tendon dysfunction remain undiagnosed owing to the
mild clinical symptoms, this series indicates that ultrasonography is a
valuable adjunctive diagnostic tool in the clinical examination and assists
in achieving an accurate diagnosis of stage I posterior tibial tendon
dysfunction, allowing early treatment.
