(Dysfunction of the posterior tibial nerve)

The posterior tibial tendinopathy, which is a degenerative disease of the posterior tibial tendon, and the posterior tibial tenosynovitis are the most common causes of retromalleoläre pain.

The posterior tibial tendinopathy, which is a degenerative disease of the posterior tibial tendon, and the posterior tibial tenosynovitis are the most common causes of retromalleoläre pain.

(See also overview of diseases of the feet and ankles.) The posterior tibial tendinopathy, which is a degenerative disease of the posterior tibial tendon, and the posterior tibial tenosynovitis are the most common causes of retromalleoläre pain. The posterior tibialis is located immediately behind the medial malleolus. The degeneration is the result of long-lasting biomechanical problems such. B. excessive pronation (often in obese people) or chronic tenosynovitis. The tenosynovitis of the tendon sheath begins with an acute inflammation. The tendon may be affected by primary inflammatory diseases such as RA or gout. Symptoms and complaints in the early stages, there is an occasional pain behind medial malleolus, with time reinforced this, it creates a painful swelling behind the ankle. Normal Standing, walking around and standing on the toes are difficult. If the tendon tears (z. B. chronic tendinitis), the foot can flatten acute (sheet collapse), and the pain can extend into the sole. When tenosynovitis of pain is usually acute and the tendon feels thick and swollen how she runs around the medial malleolus around. Diagnosis MRI Clinical findings allow diagnosis. Palpation of the tendon in inward and plantar flexed foot against resistance causes pain while out in the rule. Standing on the toes is also painful or even impossible if the tendon been torn or severely dysfunctional. Pain and swelling with tenderness of the posterior tibialis behind the medial malleolus suggest a tenosynovitis. A unilateral arch collapse with medial prominence of the ankle and Vorfußabduktion (symptom of too many toes) is particularly suggestive of an advanced tendon disease and warrants investigation on tendon rupture. MRI or ultrasound can an accumulation of fluid around the tendon (suggesting a tenosynovitis suggesting) or the extent of chronic degradation or rupture of the tendon with associated tendinitis confirm. Therapy and orthotic supports or surgery For complete rupture of a surgical procedure is necessary when a normal function is the goal. This applies v. a. for young, active patients with acute tendon tears. Conservative treatment consists of a mechanical relief to the tendon by means of customized orthoses or supporting the ankle joint with a recessed heel counter and the appropriate media key formation. the degenerative process rather exacerbated (reflections on the use of corticosteroid injections) is corticosteroid injections. In tenosynovitis rest position and an aggressive anti-inflammatory therapy are warranted.

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