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Posterior tibial tendon dysfunction: its association with seronegative inflammatory disease
M Myerson1, G Solomon, M Shereff
1Union Memorial Hospital, Department of Orthopaedics, Baltimore, MD 21218.
Foot & Ankle
|April 1, 1989
Summary
Posterior tibial tendon (PTT) dysfunction presents differently in younger patients with systemic inflammation versus older patients with mechanical issues. These findings suggest distinct causes for PTT tendinitis.
Area of Science:
- Orthopedics
- Rheumatology
- Inflammatory Diseases
Background:
- Posterior tibial tendon (PTT) dysfunction is increasingly recognized.
- Understanding its varied presentations is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To investigate the clinical and laboratory features of PTT inflammation and/or rupture.
- To identify distinct patient groups and their potential pathogeneses.
Main Methods:
- Analysis of clinical and laboratory data from 76 patients with PTT inflammation/rupture.
- Categorization into two groups based on age, clinical presentation, and systemic involvement.
Main Results:
- Group A: Younger patients (mean age 39) with systemic inflammation (enthesopathy, psoriasis, etc.).
- Group B: Older patients (mean age 64) with isolated PTT dysfunction, likely due to mechanical trauma and degeneration.
- Significant differences observed in demographics, family history, HLA data, and surgical pathology between groups.
Conclusions:
- Two distinct pathogeneses for posterior tibial tendinitis are suggested: systemic inflammatory disease versus mechanical/degenerative processes.
- Group A represents local manifestations of a systemic inflammatory disorder.
- Group B reflects the effects of mechanical trauma and degeneration.