Abstract:
BACKGROUND:Posterior tibial tendon dysfunction (PTTD) is a common malady leading to acquired flatfoot, which frequently causes foot and ankle pain and swelling. We hypothesized that patients with PTTD and pitting edema along the course of the posterior tibial tendon (PTT) would have evidence of fluid within the tendon sheath on MRI. We introduce and validate a novel, yet simple physical examination finding, the posterior tibial edema (PTE) sign, to help distinguish PTTD from other causes of foot and ankle pain and swelling. PATIENTS AND METHODS:To determine an association between the PTE sign and changes to the PTT evident on MRI, we reviewed the medical records of patients with PTTD who underwent magnetic resonance imaging (MRI). RESULTS:Of 186 patients identified with PTTD, 49 underwent MRI, and 42 (86%) demonstrated imaging characteristics consistent with tendonitis, tendinosis, or tenosynovitis. Presence or absence of increased posterior malleolar pitting edema agreed with presence or absence of these MRI findings in 43 patients (88%), making the clinical examination finding significantly predictive of MRI results (p= 0.01). The sensitivity of the test for PTE was 86%, with specificity of 100%. CONCLUSION:The PTE sign refers to pitting edema along the course of the PTT, not associated with acute trauma and not accompanied by other areas of edema. Physical examination signs that are highly sensitive and specific to the condition may help lower the cost of diagnosis by eliminating the need for expensive tests that are not always necessary.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
DeOrio JK,Shapiro SA,McNeil RB,Stansel Jdoi
10.3113/FAI.2011.0189subject
Has Abstractpub_date
2011-02-01 00:00:00pages
189-92issue
2eissn
1071-1007issn
1944-7876pii
50048444journal_volume
32pub_type
杂志文章abstract:BACKGROUND:Rheumatoid arthritis (RA) can cause significant forefoot disorders. If forefoot deformity and pain are severe, surgical treatment can be considered. The aim of this study was to analyze the long-term outcomes of surgical forefoot correction per Tillmann, which involves resection of the metatarsal heads throu...
journal_title:Foot & ankle international
pub_type: 杂志文章
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更新日期:2019-07-01 00:00:00
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journal_title:Foot & ankle international
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journal_title:Foot & ankle international
pub_type: 临床试验,杂志文章,随机对照试验
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abstract:BACKGROUND:The timing and strategy for operative treatment of flatfoot are still controversial. The purpose of this study was to evaluate clinical outcomes and radiographic changes following calcaneal Z osteotomy combined with subtalar arthroereisis for severe adolescent flexible flatfoot. METHODS:Data were analyzed f...
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journal_title:Foot & ankle international
pub_type: 杂志文章
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journal_title:Foot & ankle international
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journal_title:Foot & ankle international
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pub_type: 杂志文章,评审
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journal_title:Foot & ankle international
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.3113/FAI.2007.1124
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Metatarsalgia is frequently associated with hallux valgus. The aim of this study was to evaluate how the relative length and position of the first metatarsal head influenced metatarsalgia and plantar callosities beneath the lesser metatarsal heads. METHODS:A retrospective analysis of the clinical data and r...
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更新日期:2004-04-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,评审
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