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OrthoVellum

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Foot & Ankle
intermediate
X-Type

Posterior Tibial Tendon Dysfunction

Tendon Disorders

A 56-year-old obese woman presents with progressive medial ankle pain and a flatfoot deformity over 2 years. She has difficulty walking and standing for prolonged periods. Examination reveals hindfoot valgus, forefoot abduction ("too many toes" sign), and inability to perform a single-leg heel rise on the affected side. There is tenderness along the posterior tibial tendon behind the medial malleolus. Passive correction of the hindfoot valgus is possible. Radiographs show an increased talonavicular uncoverage angle. Regarding posterior tibial tendon dysfunction (PTTD):

Mark each as TRUE or FALSE

A

The posterior tibial tendon (PTT) is the primary dynamic stabilizer of the medial longitudinal arch ...

B

The Johnson and Strom classification stages PTTD: Stage I (tenosynovitis with preserved arch), Stage...

C

The anterior tibial tendon is the primary arch support; PTTD is rare in adults; young athletic males...

D

Stage I treatment is conservative with immobilization (boot/brace), NSAIDs, and custom orthotics wit...

E

MRI shows PTT degeneration, tearing, or complete rupture with fluid in the tendon sheath; radiograph...

Answer the questions to see explanations

Click T (True) or F (False) for each option