Standardisierter Einsatz bildgebender Verfahren (Sonographie/MRT) zur Darstellung der Sehne des M. tibialis posterior bei Tibialis-posterior-Dysfunktion

摘要

Ultrasound and MRI have proven to be significant imaging procedures in demonstrating tendon alterations in patients suffering from posterior tibial tendon dysfunction. Presently ultrasound and MRI are frequently applied both simultanously and-in part-also as alternative methods. A complementary application of the two cross-sectional imaging procedures with regard to their validity and reliability may significantly enhance the efficacy of diagnostic tools visualizing posterior tibial tendon dysfunction. In this study we investigated the significance of each imaging procedure in the case of clinical questionability of posterior tibial tendon dysfunction. This is presented in detail referring to our own experience in clinical applications of ultrasound and MRI and also with regard to current literature on this subject. We used standardized ultrasound with a quantitative assessment as the primary diagnostic tool in order to develop a concept for diagnostic application of imaging procedures in the case of tendon alterations in posterior tibial tendon dysfunction. By means of ultrasound including a quantitative assessment, the clinical questionability can be verified and serve as a cost-effective clinical follow-up in the case of conservative therapeutic trials. In order to assess secondary concomitant alterations in posterior tibial tendon dysfunction and for pre-operative planning, standardized MRI may be applied. A systematic procedure of visual diagnosis of posterior tibial tendon dysfunction enables an early therapeutic approach which can be adapted according to the stage of the disease thus aiming to prevent rapid progredient foot deformations in posterior tibial tendon dysfunction.