title: The prevalence of symptomatic posterior tibialis tendon dysfunction in women over the age of 40 in England.
abstract: BACKGROUND
  To investigate the prevalence of posterior tibial tendon dysfunction (PTTD) in women over the age of 40.
  
  
  METHODS
  A validated survey was posted to a random sample of 1000 women (over 40 years) from a GP group practice in Hertfordshire, England. Survey positive women were telephoned and when indicated, a detailed examination was performed.
  
  
  RESULTS
  There were 582 usable responses. The majority indicated they had minor forefoot or no problems. Telephone contact was made with 116 women and of those 79 required examination. The diagnosis of symptomatic flatfeet was made in 9 patients, 7 patients had stage I PTTD, 12 patients had stage II PTTD and 9 patients had an adult acquired flatfoot deformity.
  
  
  CONCLUSIONS
  This is the first report of the prevalence of stage I and II PTTD in women (over 40 years). The prevalence is 3.3% and all patients were undiagnosed despite characteristic and prolonged symptoms.
authors.affiliation: Royal National Orthopaedic Hospital Trust, United Kingdom. juliegatzoulis@homechoice.co.uk
authors.forename: J
authors.initials: J
authors.lastname: Kohls-Gatzoulis
authors.forename: B
authors.initials: B
authors.lastname: Woods
authors.forename: J C
authors.initials: JC
authors.lastname: Angel
authors.forename: D
authors.initials: D
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037081:Posterior Tibial Tendon Dysfunction / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011795:Surveys and Questionnaires