Flexor Dig. Longus Tendinitis?

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Dear All.
I need some help. The case is a 55 year old man, fairly active.After 5 hours of walking he experienced a tenderness on the outside of his left foot. After that, he experiences pain when walking which makes him limp.
Both feet overcompensated rearfoot varus (excessive pronation) with collapsed lateral column. The tenderness is experienced when foot is extended or touched on the dorsal site around the 5th met. head. This makes me assume a tendinitis of the extensor digitorum longus. I bandaged the foot in order to reduce the extension of the foot during walking and adviced for anti-inflammatories. I did not take the excessive pronation into consideration at all. Could you suggest anything to support this management or to suggest something different? Should i control the excessive pronation as a long term treatmnet? Do you think it plays role in the tendinitis? Is it a tendinitis?
Any suggestions will be appreciated.Thanks a lot.

 

Just a thought, but could it be a stress fracture of the fifth metatarsal?
When you say 'collapsed lateral column', do you mean that the fifth metatarsal is dorsiflexedand not in contact with the ground, or that it is abducted and the forefoot splayed?

 

I mean abducted and forefoot splayed...Thanks for the thought...HoweverI think it is a tendinitis...It seems to resolve now. My appproach worked with delay

 

I think you need to be more definitive with your diagnosis. Have you identified the muscle as the source of pain? Have you stress tested ligs? Is there a capsular pattern etc. etc. (see Cyriax) What about the nature of the pain?(See Maitland)

If you need more help with this please feel free to ask.

 

I thought that the dorsiflexion of the toes plus then tenderness only by touch on the dorsal site of the 5th MPjt might indicate the tendinitis of the extensor dig longus.How more specific can one be on a tendinitis?Unfortunately i am unaware of Cyriax and Maitland.I would really appriciate it if you could give me more information Simon and guide me at this case..
Thanks a lot in advance

 

Sorry i meant tenderness by dorsiflexion of the toes on the dorsal site of the 5th MPjt...