Prevalence of Abnormal Ultrasound Findings in Asymptomatic Posterior Tibial Tendons

Abstract

Background: Posterior tibial tendon dysfunction (PTTD) is a pathological condition that can cause failure of the posterior tibial tendon (PTT). Initially, patients with PTTD are often asymptomatic, making early identification and treatment challenging. Certain ultrasound (US) characteristics have been implicated in the presence of tendinopathy, but their frequency has yet to be assessed in the PTT. The purpose of this study was to identify and report on the frequency of incidental, or potentially early subclinical, tendinopathic US characteristics in asymptomatic PTTs. Methods: Following institutional review board approval, 150 participants underwent a bilateral-comprehensive US assessment. The resulting images were reviewed and assessed to identify the presence of abnormalities demonstrated to represent tendinopathy. Results: Overall, 266 tendons were assessed and 128 (48.1%) were determined to have at least one tendinopathic trait. Specifically, 51 (19.2%) had circumferential fluid, 69 (25.9%) had noncircumferential fluid, 22 (8.3%) had thickening, 31 (11.7%) had heterogenicity, 19 (7.1%) had hyperemia, and 2 (0.8%) had calcification. Additionally, Caucasian participants were found to be nearly 3 times more likely to have tendinopathic findings when compared with African American participants. Conclusion: Sixty-seven percent of participants and 48.1% of PTTs evaluated had at least one tendinopathic feature identified on US. The prevalence rates of these findings, observed in participants, were as follows: noncircumferential fluid, circumferential fluid, heterogenicity, and thickening. Knowing the frequency of these traits may help clinicians to identify subclinical tendinopathy in the PTT before it progresses to PTTD. Level of Evidence: Level IV, case series.

Prevalence of Abnormal Ultrasonographic Findings in Asymptomatic Peroneal Tendons

“…A similar study, which shared participants with the current study, focused on identifying the prevalence of US findings in posterior tibial tendons (PTTs). 14 Increased BMI was a significant risk factor for the prevalence of abnormal US findings of PTTs in African American participants, which is different from the findings of this study of the peroneal tendons. Also in this study, Caucasian participants were found to have almost 3 times higher odds of having abnormal US findings of the PTT.…”

Clinical Tests of Tibialis Posterior Tendinopathy: Are They Reliable, and How Well Are They Reflected in Structural Changes on Imaging?

“…35 A recent study found that 67% of participants, and almost half (48.1%) of tibialis posterior tendons, evaluated by ultrasound examination had changes considered to be tendinopathy, despite participants not having medial foot/ankle pain. 22 Even though the link U OBJECTIVE: To determine the reliability of common clinical tests for tibialis posterior tendinopathy (TPT) and to investigate their relationship with grayscale ultrasound findings in individuals who have medial foot/ankle pain.…”

Anatomical Study of Sites and Surface Area of the Attachment Region of Tibial Posterior Tendon Attachment

“…The existence of ethnic differences in foot muscles has been suggested in several papers [ 4 , 19 ]. Caucasian individuals were found to be nearly three times more likely to show tendinopathic findings when compared to African American individuals according to a study using ultrasound [ 20 ]. Additionally, a previous study suggested high morphological variability of the TPT in relation to the insertion location, along with the possibility of significant differences according to ethnic group and gender [ 8 ].…”