Ultrasound Assessment of the Tibialis Posterior Tendon

The patient was a 52-year-old woman with a chief complaint of left medial foot and ankle pain for the past 12 months that was of an insidious nature and on a worsening trend. High-frequency ultrasound was used to measure and assess the integrity of the tibialis posterior tendon and potentially provide further insight into the source of the symptoms. Examination of the left involved tibialis posterior tendon revealed gross abnormality with tendon enlargement, disruption in tendon structure, and fluid surrounding the tendon. The patient was subsequently diagnosed with left stage II (flexible flatfoot deformity) posterior tibial tendon dysfunction. The initial intervention included the use of an orthotic device designed, in theory, to address both the inflammatory and degenerative processes by unloading the tibialis posterior tendon and applying compression to the ankle. The goal, following a decrease in pain and acute inflammation, was to encourage tibialis posterior tendon loading through targeted progress...