54-year-old female with hindfoot valgus and posterior tibial tendinitis. Evaluate for posterior tibial tendon insufficiency. TENDONS: Again seen is deformity of the peroneus brevis tendon consistent with a longitudinal split tear at the level of the distal fibular tip. There is marked thickening and intermediate signal abnormality within the posterior tibialis tendon consistent with moderate to severe tendinosis. There is deformity and increased fluid signal abnormality within the distal inframalleolar tendon indicating a partial thickness/interstitial tear. The extensor tendons appear intact. There is a small amount of fluid within the tendon sheath of the tibialis anterior tendon which may be of no current clinical significance. The Achilles tendon is normal in appearance.LIGAMENTS: The lateral collateral ligament complex appears intact. The distal tibiofibular syndesmotic complex appears intact. The visualized components of the deltoid ligament appear intact. The cervical and interosseous talocalcaneal ligament are poorly visualized due to edema type signal abnormality within the sinus tarsi. ARTICULAR SURFACES AND BONE: There is increased signal abnormality within the body of the talus and calcaneus, most pronounced along the anterior margin of the posterior facet of the subtalar joint, with associated subchondral cyst formation likely degenerative in etiology.ADDITIONAL
1. Partial thickness tearing of the posterior tibialis tendon and the posterior tibialis tendinosis.2. Longitudinal split tear of the peroneus brevis.3. Signal abnormality within the sinus tarsi suggesting sinus tarsi syndrome.4. Degenerative osteoarthritic changes of the subtalar joint.