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Hello.

I am Guinue who is Podiatry student.

I have one question about the case, Can I ask here?

(1) Patient is experiencing medial arch pain for 5 months
(2) This pain is worse after the rest, and gets worse during prolonged weight-bearing
(3) Pain is palpable along medial cuneiform and base of the 1st metatarsal
(4) Pain when inverting the foot against resistance

In this case, can we suspect tibialis anterior insertional tendinitis, first?


Or to diagnose tibialis anterior insertional tendinitis, asking the patient whether pain located in the front of the ankle, or pain on passive ankle dorsi-flexion?

It is a bit hard to differentiate b/w tibialis anterior and tibialis posterior tendinitis, or possible the subluxation of medial cuneiform although no information about palpable pain on navicular bone....

I found one journal article about 'Distal tendinosis of the tibialis anterior tendon', but still confusing to determine diagnosis with that case...

Thank you

 

In this area, there are numerous other causes of pain as well.

You'd need to consider Dorsal midfoot interosseous compression syndrome, as well as symptomatic os naviculare. The insertion of the tibialis posterior tendon is also in this neighbourhood.