DIAGNOSTIC EFFICACY OF ULTRASONOGRAPHY IN STAGE-I POSTERIOR TIBIAL TENDON DYSFUNCTION - SONOGRAPHIC-SURGICAL CORRELATION

The purpose of this study is to evaluate the diagnostic efficacy of ul trasonography in stage I posterior tibial tendon dysfunction. Fourteen of the 17 consecutive patients who underwent tenosynovectomy for stag e I posterior tibial tendon dysfunction were included in this study Th e preoperative diagnosis was based primarily on the clinical suspicion of dysfunction, which was confirmed by ultrasonography. Two measureme nts were obtained at the midpoint between the insertion site and the m edial malleolus in both feet of the 14 patients: the diameter of the p osterior tibial tendon and the diameter of the tendon sheath measured from its inner walls. The mean diameter of the tendon was 4.61 +/- 0.5 0 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, res pectively. Ln the symptomatic tendon, the increase of peritendinous sp ace was significantly higher than the increase in the tendinous portio n (P < 0.0001). Surgical findings proved the accuracy of diagnosis in all patients. Although many cases of stage I posterior tibial tendon d ysfunction remain undiagnosed owing to the mild clinical symptoms, thi s series indicates that ultrasonography is a valuable adjunctive diagn ostic tool in the clinical examination and assists in achieving an acc urate diagnosis of stage I posterior tibial tendon dysfunction, allowi ng early treatment.