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MIDFOOT

Jump to tibialis posterior dysfunction / midfoot arthritis / cavovarus foot / ganglion

 

Tibialis posterior dysfunction

Also known as adult acquired flat foot, this is a common problem in middle-aged women. The tibialis posterior tendon runs behind the medial malleolus and inserts principally into the navicular. It inverts the foot in plantarflexion and acts as a dynamic support of the arch. It may become degenerate and tear or rupture. The result is initial pain and swelling followed by collapse of the arch, hindfoot valgus, inability to stand on tip toes and, if left untreated, arthritis of the subtalar and ankle joints.

 

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Treatment depends on the stage of the disease:

 

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Midfoot arthritis

The exact symptoms and examination findings are dependent on which of the joints in the midfoot are affected by osteoarthritis or rheumatoid arthritis.

 

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Cavovarus foot

Cavovarus deformity is a combination of a high arch (cavus) and in-turned heel (varus). Clawing of the toes, repeated ankle sprains and metatarsalgia is often also present. Causes may be idiopathic or neurological, including spina bifida or Charcot-Marie-Tooth disease.

 

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Ganglion

A ‘bulge’ of a joint capsule in which a one-way valve effect creates a gradually enlarging swelling. In the foot they may arise from any joint but are most common in the joints of the midfoot.

 

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