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
Turan A et al
- 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