Tip of Medial Malleolus- Possible Posterior Tibialis Tendonitis -Treatable Option – Os Subtibiale Bone Ossicle

Posterior Tibialis Tendonitis with medial ankle pain below medial malleolus is a difficult issue. The tendon is usually in process of tearing and so cortisone injection in not usually an option. On occcasion, a bone ossicle just below the medial malleolus called Os Subtibiale can be located by xrays. Treatment could include “conservative treatment”, removal” or bone grafting to malleolus

Skeletal Radiol. 2017 May;46(5):705-714. doi: 10.1007/s00256-017-2601-1.
Posterior tibial tendon impingement due to os subtibiale: a case report and
up-to-date review.
Turan A et al
https://www.ncbi.nlm.nih.gov/pubmed/28255943

  • 11 cases mostly with pain around medial malleolus
  • xrays then CT were used
  • Their conservative treatments were rest, NSAID’s and stretch/strengthening.
  • If Ossicle is larger than 10 mm, then fixation of bone to medial malleolus was suggested
  • Otherwise removal was suggested

Comment – without proper diagnosis, condition could drag on for some time. I wonder if prolotherapy, to adhere it more to medial malleolus, might help.

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