Tibialis Anterior Tenosynovitis

Home
About Us
- - About Us
  - About AMSSM
  - FAMSSM Designation
  - Awards
  - Founders
  - Past Presidents
  - Board of Directors
  - Committees
  - Contact Us
  - Bylaws/Policy & Committee Handbooks
- - FAMSSM Applications
  - Application submission is now closed for the 2026 Class of AMSSM Fellows. New Fellows will be announced to the AMSSM membership after the first of the year and honored at the 2026 Annual Meeting.
    
    Applications for the FAMSSM Designation will be available on an annual basis. Please contact Ellen Glasgow with any questions regarding the FAMSSM application.
- - We Understand You

Communications
- - Communications
  - Collaborate.AMSSM.org
  - New Branding Campaign
  - AMSSM Member Marketing Toolkit
  - Journal Access
  - Publications/Position Statements
  - Press Releases
  - Brochures
  - Weekly Digests
- - Online AMSSM Community for Members
  - AMSSM Collaborate online community provides a forum for year-long connection, giving members the chance to have conversations, share resources and make connections with your peers.
- - AMSSM Informational Brochures
  - Find informational brochures about sports medicine physicians geared toward coaches, parents and other healthcare professionals.
Education
- - AMSSM Sports Medcasts
  - Find all current and past AMSSM Sports Medcast episodes in one convenient location.
- - AMSSM Fellow Online Lecture Series
  - The AMSSM National Fellow Online Lecture Series features talks from national experts on fundamental sports medicine topics pertinent to fellowship training and sports medicine board certification. Go to the collaborate.amssm.org site and view the available lectures in the Upcoming Events area.
Research
Advocacy
- - Legislative and Policy Issues
  - AMSSM is the go-to organization for legislative and policy issues related to sports medicine and athlete health and safety.
- - Legislation by State
  - AMSSM offers a variety of advocacy resources, including a map that tracks legislation important to sports medicine physicians.
Sports US
- - Sports Ultrasound Online Didactics
  - These 35 educational modules cover all of the didactic instructional session topics recommended for sports medicine fellows by the AMSSM.
- - Sports Ultrasound Committee
  - Find all the resources, materials and guidelines from the AMSSM Sports Ultrasound Committee
Patients
- - Need a Sports Medicine Physician?
  - FindADoc
- - SportsMedToday.com
  - Your comprehensive sports medicine resource for athletes, coaches and parents.
Additional Information
- - Additional Information
  - Sports Med Today
  - Journals
  - Weekly Digests
  - Store
  - Careers
  - Industry
Foundation

Tibialis Anterior Tenosynovitis

Authors, Editors, Case Information Author: David Ross, MD Affiliation: Ross Medical Group, Miami, Florida Co Author(s): Mehak Sharma, MD. Department of Internal Medicine, FIU Herbert Wertheim College of Medicine, Bruce W. Carter VA Medical Center, Miami, Florida. Jackson Memorial Hospital, Miami, Florida. Senior Editor: William Berrigan, MD Clinical Vignette: A 69-year-old man presents with acute left ankle pain following a hiking trip in the mountains. He walked up and downhill in flat boat shoes for several hours. On awakening the next day, he noticed swelling in the anterior aspect of his ankle along with severe pain with predominantly dorsiflexion of his ankle. Physical examination in the Sports Medicine office reveals bilateral pes planus. There is limited left plantarflexion and dorsiflexion with both active and passive range of motion.left sided limitation in active and passive dorsiflexion. He has 5/5 strength with ankle plantarflexion and dorsiflexion, and severe pain with resisted ankle dorsiflexion. Type of Probe Used: 8-12 MHz Linear Transducer Labeled Short Axis View of the Tibialis Anterior Tendon Labeled Short Axis view of the tibialis anterior tendon demonstrating the anterior tibialis tendon (ovoid structure) surrounded by a hypoechoic to anechoic fluid collection within the tendon sheath, consistent with tenosynovitis. Unlabeled Short Axis View of the Tibialis Anterior Tendon Unlabeled Short Axis view of the tibialis anterior tendon. Labeled Long Axis View of the Tibialis Anterior Tendon Labeled Long Axis view of the tibialis anterior tendon demonstrating anechoic fluid surrounding the anterior tibialis tendon along its course, with preserved tendon fibrillar architecture and no evidence of discrete tear or significant tendon thickening. The distal tibia is visualized as an intact hyperechoic bony cortex proximally and deep. Unlabeled Long Axis View of the Tibialis Anterior Tendon Unlabeled Long Axis view of the tibialis anterior tendon. Interpretation Image Interpretation: Tibialis anterior tendon is surrounded by a hypoechoic to anechoic fluid collection within the tendon sheath, consistent with tenosynovitis. The tendon appears ovoid with circumferential fluid tracking along its periphery. Fluid is seen surrounding the tendon along its course, with preserved tendon fibrillar architecture and no evidence of discrete tear or significant tendon thickening. The distal tibia is visualized as an intact hyperechoic bony cortex posteriorly. Teaching Pearl: Tibialis anterior tenosynovitis is an underrecognized cause of anterior ankle pain in active patients. In an older patient, it can be common to think of degenerative ankle joint disease as a primary etiology. A thorough history including footwear selection and activity type is essential, as inadequately supportive footwear worn during hiking may fail to provide necessary ankle stabilization. This can place excessive and repetitive mechanical load on the tibialis anterior tendon. Point of care ultrasound is a useful imaging modality for localizing anterior ankle pathology and differentiating tenosynovitis from intra-articular disease. Circumferential anechoic fluid tracking within the tendon sheath with preserved internal fibrillar architecture is a hallmark sonographic finding of tenosynovitis and can help distinguish it from other causes of anterior ankle pain. Systematic scanning in both transverse and longitudinal planes is critical to avoid misattributing tendon sheath pathology to intra articular disease, particularly in older patients where degenerative disease is more common.
NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

Back		Top

UPCOMING EVENTS

_________________________________

12/11-12/13/2025
2025 Advanced Team Physician Course

_________________________________

1/09-1/11/2026
2026 AMSSM/South Bend Sports US

FIND A SPORTS DOC

Please enter a search term relevant to the search type. For US States - use only letter abbreviations.

Choose Search Type

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415

Website created by the computer geek

Authors, Editors, Case Information

Labeled Short Axis View of the Tibialis Anterior Tendon

Unlabeled Short Axis View of the Tibialis Anterior Tendon

Labeled Long Axis View of the Tibialis Anterior Tendon

Unlabeled Long Axis View of the Tibialis Anterior Tendon

Interpretation

UPCOMING EVENTS

FIND A SPORTS DOC