Weight-bearing foot radiography may be used to evaluate posterior tibial tendon integrity
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Weight-bearing anteroposterior foot radiography may better predict the prognosis of patients with posterior tibial tendon dysfunction compared with ultrasonography or MRI, according to published results.
Researchers from the department of orthopedic surgery at the Seoul National University Bundang Hospital retrospectively analyzed data for 21 consecutive patients who underwent bilateral weight-bearing foot radiography and ultrasonography for the suspicion of posterior tibial tendon dysfunction (PTTD).
According to the study, two orthopedic surgeons independently compared the diagnostic accuracy of anteroposterior foot radiography with ultrasonography based on interobserver agreement and accuracy. Surgeons scored tendon integrity as either normal or abnormal.
Ultrasonographic results revealed four patients had normal tendon integrity, six had tenosynovitis, eight had tendinopathy and three had loss of tendon continuity. Radiographic results showed agreement on 17 of 21 cases, with disagreement on three cases of confirmed tendinopathy and one case of an intact tendon, according to the study.
Researchers deemed that with 81% confirmation accuracy, weight-bearing anteroposterior foot radiography can be used as a screening tool for evaluating posterior tibial tendon integrity and PTTD.
“Screening of the structural integrity of the posterior tibial tendon is important for diagnosing the cause and planning treatment and follow-up,” the researchers wrote in the study. “Severe tendinopathy with changes in tendon thickness and loss of tendon continuity could be visualized on foot radiographs, although milder tendinopathy was not detected accurately,” they concluded.
“Refinements to the radiographic technique and setting are needed to improve the resolution of this modality,” they wrote.
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