[Tenography in tenosynoviopathies of the posterior tibial tendon].
OBJECTIVE
The authors wanted to study diagnosis contribution and therapeutic importance of tenography in posterior tibial tendon tenosynoviopathies.


METHODS
The series included 42 patients (26 females and 16 males) from 23 to 69 years old. The affection had a course for about two years. A trigger or promoter factor was founded in 32 cases. Clinical examination found only 12 standard feet. Biological exams were normal.


METHODS
All patients had a tenography. When tenosynoviopathy was diagnosed, the surgeon injected cortivazol in the sheath by the catheter, within the extra-tendinous space. In case of treatment failure, a synovectomy was realized with possible tendinous suture, under the protection of a weight bearing plaster cast for 21 days.


RESULTS
Pathological features: we have founded 26 major irregularities of the sheath, extensive with scalloped outlines of which 8 were supra-malleolar and 18 sub-malleolar, 15 irregularities located at the level of the sheath outline of which 4 were supra-malleolar and 11 sub-malleolar and with a tear of 1 cm length. Long term results: among 36 reviewed patients, pain disappeared in 29 cases, after only one injection (21 cases), or after a surgical treatment (8 cases).


CONCLUSIONS
Tenography has for us great interest for the diagnosis of a tenosynoviopathy, allowing in the same time an extra-tendinous injection of corticoid in the sheath itself. But it doesn't always allow to make a diagnosis of a tendinous tear. A part of our failures can be secondary to these tears. According to our results it could be recommended to practice in a first time a tenotomodensitometry (teno TDM). In case of a tear, a surgical treatment by synovectomy with suture may be proposed first, for a tenosynoviopathy an injection must be realizes.


CONCLUSIONS
Tenography allows a precise diagnosis and in the same time, a treatment by injection. The tendinous tears require a surgical suture but are better diagnosed on a teno TDM.
Jardé
O
O
Service de Chirurgie Orthopédique, Hôpital Nord, Amiens.
Baratte
B
B
Cordonnier
C
C
Grumbach
Y
Y
Vives
P
P
D000328:Adult; D000368:Aged; D000843:Ankle Joint; D003952:Diagnostic Imaging; D005260:Female; D005534:Foot Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013583:Synovial Membrane; D013708:Tendon Injuries; D013710:Tendons / Q000000981:diagnostic imaging*
La ténographie dans les ténosynoviopathies du tendon tibial postérieur.