title: [Posterior tibial tendon dysfunction: what other structures are involved in the development of acquired adult flat foot?].
abstract: OBJECTIVE
  To evaluate the association of posterior tibial tendon dysfunction and lesions of diverse ankle structures diagnosed at MRI with radiologic signs of flat foot.
  
  
  METHODS
  We retrospectively compared 29 patients that had posterior tibial tendon dysfunction (all 29 studied with MRI and 21 also studied with weight-bearing plain-film X-rays) with a control group of 28 patients randomly selected from among all patients who underwent MRI and weight-bearing plain-film X-rays for other ankle problems. In the MRI studies, we analyzed whether a calcaneal spur, talar beak, plantar fasciitis, calcaneal bone edema, Achilles' tendinopathy, spring ligament injury, tarsal sinus disease, and tarsal coalition were present. In the weight-bearing plain-film X-rays, we analyzed the angle of Costa-Bertani and radiologic signs of flat foot. To analyze the differences between groups, we used Fisher's exact test for the MRI findings and for the presence of flat foot and analysis of variance for the angle of Costa-Bertani.
  
  
  RESULTS
  Calcaneal spurs, talar beaks, tarsal sinus disease, and spring ligament injury were significantly more common in the group with posterior tibial tendon dysfunction (P<.05). Radiologic signs of flat foot and anomalous values for the angle of Costa-Bertani were also significantly more common in the group with posterior tibial tendon dysfunction (P<.001).
  
  
  CONCLUSIONS
  We corroborate the association between posterior tibial tendon dysfunction and lesions to the structures analyzed and radiologic signs of flat foot. Knowledge of this association can be useful in reaching an accurate diagnosis.
authors.affiliation: Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España. Electronic address: lherraizh@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Herráiz Hidalgo
authors.affiliation: Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Carrascoso Arranz
authors.affiliation: Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Recio Rodríguez
authors.affiliation: Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Jiménez de la Peña
authors.affiliation: Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Cano Alonso
authors.affiliation: Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Álvarez Moreno
authors.affiliation: Departamento de Diagnóstico por la Imagen, Hospital Universitario Quirón Madrid, Pozuelo de Alarcón, Madrid, España.
authors.forename: V
authors.initials: V
authors.lastname: Martínez de Vega Fernández
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005413:Flatfoot / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D037081:Posterior Tibial Tendon Dysfunction / Q000150:complications* / Q000175:diagnosis*; D012189:Retrospective Studies