Posterior Tibial Tendon Dysfunction
Category: Hindfoot Introduction/Purpose: Stage 1 posterior tibial tendon dysfunction (PTTD) may be present without intra-substance tendon pathology. We hypothesize that in individuals with the clinical diagnosis of Stage 1 PTTD, with no MRI-detectable intra-substance tendon pathology, that sheath fl...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2017-09-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011417S000023 |
| _version_ | 1818516522353557504 |
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| author | Jason Bariteau MD Douglas Robertson MD, PhD William Carpenter MD |
| author_facet | Jason Bariteau MD Douglas Robertson MD, PhD William Carpenter MD |
| author_sort | Jason Bariteau MD |
| collection | DOAJ |
| description | Category: Hindfoot Introduction/Purpose: Stage 1 posterior tibial tendon dysfunction (PTTD) may be present without intra-substance tendon pathology. We hypothesize that in individuals with the clinical diagnosis of Stage 1 PTTD, with no MRI-detectable intra-substance tendon pathology, that sheath fluid amount is a confirmatory finding of PTTD. This purpose of this study was to quantify the amount of PTT sheath fluid in 1) individuals with the clinical diagnosis of Stage 1 PTTD and no MRI-detectable intra-substance tendon pathology and compare to controls with medial ankle pain (causes other) also without MRI-detectable intra-substance PTT pathology, and 2) test if there was a sheath fluid measurement predictive of the clinical diagnosis of PTTD. Methods: 326 individuals with medial ankle pain, no intra-substance PTT pathology, were studied, 48 with the clinical diagnosis of Stage 1 PTT dysfunction and 278 with medial ankle pain, causes other. Geometric methods defined MRI-based sheath fluid volume, maximum cross-sectional fluid area, and maximum fluid width. Fluid measurements were compared between groups and a predictive measurement calculated to identify individuals with PTTD. Measurement reliability was tested. Results: Individuals with PTT dysfunction had larger PTT sheath fluid volume, area, and width than controls (p’s < 0.001). An 9 mm threshold maximum fluid width was associated with PTTD (sensitivity 84%, specificity 85%). Measurements were reliable (p’s <0.03). Conclusion: The amount of PTT sheath fluid, in individuals with medial ankle pain and no intra-substance PTT pathology, was associated with Stage 1 PTTD and a maximum PTT sheath fluid width of > 9 mm predicted PTTD. This is clinically significance as MRI-detected sheath fluid can now be used as a confirmatory finding in individuals with the clinical diagnosis of Stage 1 PTTD who do not have MRI-detectable intra-substance pathology |
| first_indexed | 2024-12-11T00:43:23Z |
| format | Article |
| id | doaj.art-cafc83294f4545de9dcf2b3b56f37be2 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-12-11T00:43:23Z |
| publishDate | 2017-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-cafc83294f4545de9dcf2b3b56f37be22022-12-22T01:26:51ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142017-09-01210.1177/2473011417S000023Posterior Tibial Tendon DysfunctionJason Bariteau MDDouglas Robertson MD, PhDWilliam Carpenter MDCategory: Hindfoot Introduction/Purpose: Stage 1 posterior tibial tendon dysfunction (PTTD) may be present without intra-substance tendon pathology. We hypothesize that in individuals with the clinical diagnosis of Stage 1 PTTD, with no MRI-detectable intra-substance tendon pathology, that sheath fluid amount is a confirmatory finding of PTTD. This purpose of this study was to quantify the amount of PTT sheath fluid in 1) individuals with the clinical diagnosis of Stage 1 PTTD and no MRI-detectable intra-substance tendon pathology and compare to controls with medial ankle pain (causes other) also without MRI-detectable intra-substance PTT pathology, and 2) test if there was a sheath fluid measurement predictive of the clinical diagnosis of PTTD. Methods: 326 individuals with medial ankle pain, no intra-substance PTT pathology, were studied, 48 with the clinical diagnosis of Stage 1 PTT dysfunction and 278 with medial ankle pain, causes other. Geometric methods defined MRI-based sheath fluid volume, maximum cross-sectional fluid area, and maximum fluid width. Fluid measurements were compared between groups and a predictive measurement calculated to identify individuals with PTTD. Measurement reliability was tested. Results: Individuals with PTT dysfunction had larger PTT sheath fluid volume, area, and width than controls (p’s < 0.001). An 9 mm threshold maximum fluid width was associated with PTTD (sensitivity 84%, specificity 85%). Measurements were reliable (p’s <0.03). Conclusion: The amount of PTT sheath fluid, in individuals with medial ankle pain and no intra-substance PTT pathology, was associated with Stage 1 PTTD and a maximum PTT sheath fluid width of > 9 mm predicted PTTD. This is clinically significance as MRI-detected sheath fluid can now be used as a confirmatory finding in individuals with the clinical diagnosis of Stage 1 PTTD who do not have MRI-detectable intra-substance pathologyhttps://doi.org/10.1177/2473011417S000023 |
| spellingShingle | Jason Bariteau MD Douglas Robertson MD, PhD William Carpenter MD Posterior Tibial Tendon Dysfunction Foot & Ankle Orthopaedics |
| title | Posterior Tibial Tendon Dysfunction |
| title_full | Posterior Tibial Tendon Dysfunction |
| title_fullStr | Posterior Tibial Tendon Dysfunction |
| title_full_unstemmed | Posterior Tibial Tendon Dysfunction |
| title_short | Posterior Tibial Tendon Dysfunction |
| title_sort | posterior tibial tendon dysfunction |
| url | https://doi.org/10.1177/2473011417S000023 |
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