Jernberg E T, Simkin P, Kravette M, Lowe P, Gardner G
Division of Rheumatology, University of Washington, Virginia Mason Medical Center, Seattle, USA.
J Rheumatol. 1999 Feb;26(2):289-93.
To investigate the role of the posterior tibial tendon in the flat foot deformity of rheumatoid arthritis (RA).
Eleven patients with hyperpronated feet and 9 without hyperpronation underwent magnetic resonance imaging (MRI) of the feet and ankles. Radial oblique double echo images provided cross sectional views of the posterior tibial tendon as it coursed behind and under the medial malleolus and inserted beneath the midfoot.
Complete tears (Type III) of the posterior tibial tendon were seen in one patient with hyperpronation and in one without hyperpronation. However, partial tears (Types I and II) of the posterior tibial tendon were common, and when Type I-III posterior tibial tendon tears were grouped together, they were seen in 68% of flat feet and in 43% of feet that were not flat. Abnormalities of the tarsal sinus, including cortical erosions and replacement of the normal fat signal with intermediate signal soft tissue, were seen in 74% of flat feet and in 5% of feet that were not flat.
Posterior tibial tendon tears are common in RA flat feet, but are usually incomplete and are not solely responsible for the flat foot deformity.
探讨胫后肌腱在类风湿关节炎（RA）扁平足畸形中的作用。
对11例足旋前过度患者和9例无足旋前过度患者的足和踝关节进行磁共振成像（MRI）检查。桡侧斜位双回波图像提供了胫后肌腱在内踝后方和下方走行并插入中足下方时的横断面视图。
1例足旋前过度患者和1例无足旋前过度患者出现胫后肌腱完全撕裂（III型）。然而，胫后肌腱部分撕裂（I型和II型）很常见，当将I - III型胫后肌腱撕裂归为一组时，在68%的扁平足和43%的非扁平足中可见。跗窦异常，包括皮质侵蚀和正常脂肪信号被中等信号软组织替代，在74%的扁平足和5%的非扁平足中可见。
胫后肌腱撕裂在RA扁平足中很常见，但通常不完全，并非扁平足畸形的唯一原因。
