Flatfoot deformity ANKLE:TENDONS: Increased signal replaces the posterior tibialis tendon as it courses beneath the medial malleolus compatible with full-thickness/near-full-thickness tearing. Proximally, the tendon is enlarged with increased signal intensity likely reflecting a combination of retraction and degeneration. Additional tendinosis is noted within the distal fibers of the tendon which appear to reach the insertion upon the navicular.There is a small amount of fluid adjacent to the flexor digitorum longus and flexor hallucis longus tendons along the posterior margin of the talus and at the knot of Henry which may reflect mild tenosynovitis but is of questionable clinical significance.The tibialis anterior, extensor hallucis longus, and extensor digitorum longus tendons are intact and demonstrate a normal course. The peroneal tendons are intact. The Achilles tendon is intact. LIGAMENTS: The lateral collateral ligament complex and distal tibiofibular ligament complex are intact. The tibiospring ligament appears slightly thickened but is intact and the remaining spring ligament is also intact. Mild heterogeneity of the deep fibers of the deltoid ligament may reflect old sprain injury.JOINTS: Mild osteoarthritis affects the talonavicular articulation, subtalar joint, and midfoot. Marrow edema within the posteromedial tibial epiphysis is likely reactive, related to the aforementioned abnormalities of the posterior tibialis tendon.MUSCLES/SOFT TISSUES: There is no muscle atrophy. There is mild superficial edema and edema adjacent to the FHL. A tiny amount of fluid is noted within the tibiotalar joint but there is no sizable effusion.FOOT:There is a moderate hallux valgus deformity with moderate osteoarthritis of the first MTP joint. Mild osteoarthritis affects the Lisfranc joint, specifically the second tarsometatarsal articulation. The Lisfranc ligament is intact. The remaining marrow signal of the foot is otherwise normal.There is no muscle atrophy or tear.
1. Near-full-thickness to full-thickness tear of the posterior tibialis tendon with additional ankle findings described above.2. Moderate hallux valgus deformity and osteoarthritis of the foot.