posterior tibial tendon ( RID3194 )
There is smooth erosion (blue arrow) at the plantar medial navicular with BME. There is insertional tendinosis predominantly of the accessory slips of the PTT which insert onto the cuneiforms (red arrows);only min tendinosis of the major slip inserting onto the med navicular (white arrow). There is peroneal and distal achilles tendinosis + partial tear, which are chronic. There is chronic erosion without BME (not shown) at the posteromedial plantar calcaneus. I was wondering about gout or HADD, given the appearance of the smooth erosions and no joint involvement; though I couldnt see a tophus or calcific deposit. Turns out she has RA on anti-TNF, which control her articular involvement, but not the tendinosis or tenosynovitis. The lesson is that it is often helpful to talk to the referrer....in our ample spare time.
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