OCAD MSK

History

57F several months painful posteromedial ankle mass

Figure 1 for case flexor hallucis longus tendon ( RID3193 ) — Figure 1

Figure 2 for case flexor hallucis longus tendon ( RID3193 ) — Figure 2

Figure 3 for case flexor hallucis longus tendon ( RID3193 ) — Figure 3

Figure 4 for case flexor hallucis longus tendon ( RID3193 ) — Figure 4

Figure 5 for case flexor hallucis longus tendon ( RID3193 ) — Figure 5

Discussion

There is no soft tissue mass. In the area of interest, there is enhancing synovitis of the FHL tendon sheath, with superimposed non enhancing effusion. The tendon looks normal. There is also a non enhancing effusion of the posterior subtalar joint. My question is about image 1, which shows that there is essentially no inter tubercular groove at the posterior talar process. Normally the medial and lateral tubercle of the posterior talar process form a groove for the FHL (just like the long head biceps tendon in the arm). I wonder if this predisposes to dynamic tendon subluxation and tenosynovitis. She is not a ballerina! Certainly nothing to predispose to posterior impingement. Anyone have any idea about this?

Diagnosis

flexor hallucis longus tendon ( RID3193 )

Hilary Umans, MD

Courtesy

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