Lab Studies:
No pertinent lab data was obtained.
Other Studies:
Clinical ultrasound was negative for tenosynovitis of the flexor hallucis longus and flexor digitorum longus tendons, and compression of the posterior tibial nerve. The posterior tibialis tendon demonstrated tenosynovitis Case Photo #1 . There was a posterior malleolus osteophyte impinging into the posterior tibialis tendon Case Photo #2 . Sonopalpation at this level reproduced pain, and dynamic ankle inversion revealed further impingement.
Diagnostic block at this level provided 80% relief. Updated MRI showed split thickness tibialis posterior tendon tear near the osteophyte, and his other prior findings on initial MRI were resolved Case Photo #3 .
Consultations:
Podiatry and Pain Management
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