Posterior Tibial Tendon and Subtalar Joint Complex in Rheumatoid Arthritis: Magnetic Resonance Imaging Study

MAURICE BOUYSSET, JACQUES TEBIB, THIERRY TAVERNIER, ERIC NOEL, CHANTAL NEMOZ, MICHEL BONNIN, KARL TILLMANN, and JOCELYNE JALBY

ABSTRACT.

Objective. To observe by magnetic resonance imaging (MRI) the pathologic changes in the posterior tibial tendon (PTT), subtalar joint complex (STJC), and sinus tarsi in patients with rheumatoid arthritis (RA), and if possible to determine their involvement in the course of the disease.

Methods. Sixty-seven rheumatoid feet with mid and hindfoot pain underwent MRI with gadolinium injection. Localized enhancement and anatomic lesions were assessed in the 3 sites.

Results. On MRI, PTT involvement was seen to be more frequent than STJC or sinus tarsi. When there was gadolinium enhancement of the PTT there was no sinus tarsi enhancement (p = 0.014). Interosseous talocalcaneal ligament rupture was correlated with disability (p = 0.031).

Conclusion. In RA patients with hindfoot pain, PTT synovitis is observed when there is no sinus tarsi synovitis. (J Rheumatol 2003;30:1951-4)

Key Indexing Terms:

POSTERIOR TIBIAL TENDON
SUBTALAR JOINT COMPLEX
SINUS TARSI
RHEUMATOID ARTHRITIS

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From the Department of Rheumatology, Hôpital Edouard-Herriot, Lyon, and Department of Rheumatology, Centre Hospitalier Lyon Sud, Pierre Bénite, France.

M. Bouysset, MD, Villefranche sur Saône; J. Tébib, MD, Professor of Medicine, Service de Rhumatologie, Centre Hospitalier Lyon Sud (CHLS); T. Tavernier, MD, Service de Radiologie, Clinique de la Sauvegarde, Lyon; E. Noël, MD, Hôpital Edouard Herriot; C. Némoz, PhD, Service de Biostatistique et d'Informatique Médicale des Hospices Civils de Lyon, Lyon; M. Bonnin, MD, Orthopaedic Surgeon, Clinique Sainte Anne Lumière, Lyon; K. Tillmann, MD, Rheumaklinik Bad Bramstedt, Gmbh, Bad Bramstedt, Germany; J. Jalby, MD, Villefranche sur Saône.

Address reprint requests to Dr. M. Bouysset, 126 rue Philippe Héron, 69400 Villefranche sur Saône, France. E-mail: scm.rhumatologie-caladoise@wanadoo.fr

Submitted April 18, 2002; revision accepted February 21, 2003.

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