Background : Adult acquired flatfoot deformity (AAFD) is marked with a partial or complete flattening of the longitudinal medial arch that developed after maturity. AAFD, secondary to posterior tibialis tendon dysfunction (PTTD), is one of the most frequent foot and ankle pathologies in professional athletes. Different modality and procedures can be used to establish the diagnosis of AAFD and PTTD However, the correlation of these various clinical and imaging measurements with specific injuries of the PTT and supporting medial longitudinal arch structures has not been fully reported. The purpose of this study is to investigate the correlation between PTTD using ultrasonography and AAFD that diagnosed using both radiographic x-ray and feiss line examination.
Method : 112 professional athletes with flat foot deformity on physical examination, symptom of PTT dysfunction such as medial ankle or foot pain, focal pain along the course of the PTT underwent foot radiographic x-ray using calcaneal inclination angle, ankle ultrasound to see PTT abnormality and feiss line examination using three degree of flat foot classification.
Result : There were strong association between calcaneal inclination angle and PTTD includes the presence of PT tendon sheath fluid as well as tendon sheath thickening with p<0.05 with correlation coefficient (r) = 0.921 and 0.892 respectively. Weak association were also found between feiss line result and PT tendon sheath fluid as well as tendon sheath thickening with correlation coefficient (r) = 0.288 and 0.244. There were non significant association between calcaneal inclination and partial PT tendon tear as well as calcaneal inclination and feiss line result.
Conclusion : A compressive understanding of posterior tibialis tendon dysfunction and flatfoot diagnosis will lead to more effective management in reducing the symptom.